Friends and Fellow Sufferers!
I am becoming increasingly frustrated and angered, by what I believe to be, the deception & deceit of some spinal clinics and Spinal Surgeons, who I believe, miss-describe their spinal decompression procedures to potential patients by claiming that standard surgical procedures, like microdiscectomy, are Minimally Invasive Spinal Surgery (MISS).
As I am reading various articles and published medical papers, I often find that I read through many detailed pages, before I realize that what the author is actually describing is not a cutting edge MISS procedures like (ELFD), but 80 year old ‘open back’ procedures ‘or’ their updated and rehashed reincarnations, such as micro-discectomy for discectomy and instrumented fusion for open fusion and so on! This makes me angry, because they have just wasted my time!!!
I recently found these 2 misleading paragraphs in an unnamed clinic literature:
‘’’The technique has been developed to complement minimal invasive spinal surgery (MISS) as this often does not allow for direct visualization of the spine. In that regard both of these techniques DO NOT alter the indications or goals of surgery.’’’
‘’’Depending on the condition being treated, a ‘mini-open exposure’ reduces the size of the wound to approximately 2 to 5 cms long, and with the aid of a self retaining frame-based retractor allows for a ‘complete exposure’ of the desired area of the spine.’’’
(My objections to these paragraphs is as follows)
Complimenting (MISS)? ---------- It is the polar opposite of (MISS). LOL!!
This misleading phrase ‘places the suggestion’ that (MISS) procedures are carried out with the MISS Surgeon having ‘little or no visualization’ of the working area ‘or’ that they use Fluoroscope type X-ray machines (used to detect ‘hard’ items like bone) to visualize the working area, in order to operate on ‘soft tissue’ like discs and tendons! I believe, this is totally misleading! Truly MISS procedures use ‘coloured endoscopic cameras’ to see the spinal components from ‘within’ the spinal canal itself, millimeters away from the problem area! Not from outside the patients body or with a microscope like standard ‘open back’ procedures!
A mini-open ‘complete’ exposure? (MOE) --- Never heard of this before!
This simply means that the incision length and size is open to the outside world, greatly increasing the chance of spinal infection during the procedure! Please don’t be fooled, This is an ‘open back’ procedure!!
2 – 5 cms wound? ----------------- (MISS) is 0.50. Half of a centimeter!!!
5 cms is 2 inches! After the ‘frame based retractor’ has ‘mechanically stretched’ the wound, it is conceivable, that the wound could become as big as a 4 inch diameter 'hole' in a patients back!!!
I am not suggesting or accusing anyone of doing anything illegal or against medical practices, rules or guidelines, after all, (MISS) is not a legally patented description of a spinal surgical procedure or anything else for that matter! So in actual ‘real life’ terms, the MISS phrase ‘is no real guarantee’ of an ‘accurate’ spinal procedural description! So when you see a clinic or Surgeon advertising services as (MISS), Remember, it is down to you to make sure you read the small print!! Do your research people!!
When researching truly Minimal Invasive Spinal Surgery (MISS), please be aware of the tricks of the trade! And don’t forget, the dictionary’s description of ‘Minimal’ means:
The smallest size of,
The lowest quantity of,
The least amount of,
&
The most minimal possible.
ERGO:
The advertised wound size was up to 5 cms (2 inches).
Truly MISS procedures (ELFD) wound size is 0.50 cms (A half inch)
My fellow sufferers, which do you think is ‘correctly described’ as Minimally Invasive Spinal Surgery?
Best wishes AND HAPPY RESEARCHING
SPINELF
Spinilif,
I hear you. An interesting additional point is why are ANY surgons still making very large insisions. Mine was about 3 cm but my husbands was about 8 cm
Warning Warning Danger Will Robinson!
Am I the only one to think that on reading the title?
A very serious topic though and one that really causes me a lot of anquish when I hear of people that have had large open wounds and unsatisfactory surgery. Thanks for posting this 🙂
Lizzy the difference may also be if your husband is very much larger than you and so has bigger vertebrae, nevertheless neither could be classed as MISS.
Spinilif,
I hear you. An interesting additional point is why are ANY surgons still making very large insisions. Mine was about 3 cm but my husbands was about 8 cm
Interesting point indeed LizzyH! :confused:
What’s interesting to understand, is that so called ‘Gold Standard’ open back spinal procedures used in the NHS and private spinal clinics today, are all largely based upon procedures that were introduced 80-100 years ago, and have changed little since. Fusion for example, was introduced around 1908 to help straighten the spines of TB sufferers who experienced severe spinal curvature, as a symptom of their disease. This ‘last resort’ procedure, helped to prevent the crushing of the TB sufferers ‘vital organs’ thus increasing their life expectancy! It was also noted, that TB sufferers experienced a general decrease in pain levels in the spinal area, and that’s another reason why they used this ‘last resort’ but destructive and morbidity inducing Treatment!
Spine Surgeons of ‘that period’ decided to use this ‘last resort’ treatment because of that pain relieving factor and because ‘really’ they had ‘effectively’ very little else to offer disc compression sufferers or sufferers with spinal stenosis!
Throughout the 90’s and 00’s in America (and I suspect Britain too), Fusion became one of the top most commonly used spinal procedures carried out by Spine Surgeons, but not as a ‘last resort’ treatment, but instead, as a ‘first option’, even though the destructiveness and morbidity issues still remained and the long term clinical outcomes for back pain patients were still wholly questionable, and still are!!
So why are they still doing open procedures with large incisions?
I believe, it is because of the Surgeons adherence to these old procedures, the procedures they were trained for and because (as a Doctor told me, confidentially) Surgeons do, what Surgeons do, they cut!!
I also believe, it is largely because of the ‘old dog, new trick’ syndrome! Let me explain! MISS procedures have been around for 25 years+, but if a Surgeon has been trained in ‘standard’ procedures for 10 years (20 years ago) and is ‘not required’ to retrain as an MISS Surgeon or carry out less invasive procedures, where is the incentive to make a Quantum leap in changing direction?
My experience also tells me that there is an ‘institutional bias’ against the move towards MISS, although I accept that some Surgeons are 'now' making quiet and tentative steps into the MISS & MAS approaches! Yet try getting an NHS Spine Surgeon to ‘openly and calmly’ discuss an MISS treatment route for you and see what happens! I have experienced denials, misdirection’s, deceit and even lies, to firstly ‘down play’ MISS’s obvious benefits & advantages, then to ‘play up’ the clinical outcomes of ‘standard’ procedures. I am still looking for this information after 7 years of disability.
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Cassie!
Well spotted!
Great minds think alike and all that!!:)
You were 'spot on' with the lost in space connection! When I read the rubbish on that web site, my arms started flailing around in disbelief, just like the Robots!! LOL!!!