Minimally Invasive Spine Surgery (MISS): A Revolution in Care

Spine surgery is an ancient craft dating back at least 5,000 years. Its history begins with the Egyptian mummies and includes Hippocrates, often referred to as the “father of spine surgery.” In this long chronicle of spine surgery, the last few decades have seen extensive developments. The advent of tools for microscopic and endoscopic procedures have made minimally invasive surgery not only possible but remarkably effective with greatly improved surgical results, shorter hospital stays, reduced costs and fewer complications.

Dr. Chong K. Oh is a board certified orthopedic surgeon and spine surgery specialist with a background and special interest in minimally invasive procedures. He explains as follows,

Traditional spinal surgery is typically done through a midline open incision that spans the spinal levels that require treatment. It requires stripping of the paraspinal musculature for access to the bony anatomy and neural structures. Multilevel procedures require a longer incision and more soft tissue stripping because the spinal levels are stacked on top of each other.

Unlike other parts of the body that lend themselves more readily for treatment with small instruments and cameras (the knee or shoulder, for example), the spinal architecture does not typically allow for this kind of approach. As spinal surgeons, we are guided by the patient’s symptoms and imaging studies and plan for delicate and precise work in the anatomical areas that require our attention.

Minimally invasive spinal techniques have been made possible by technological advances made since the early 1990s. Advances in fluoroscopy (real-time X-rays) have greatly aided in the progress of the field. Smaller and better retractor systems allow the surgeon to use smaller incisions, as well as less stripping and pulling of the musculature for access to the spine. When instrumentation is required, newer implants have smaller footprints and are more friendly to the bony anatomy of the spine. In turn, these techniques translate into less bleeding and shorter hospital stays.

The general goal of minimally invasive spine surgery is to stabilize the vertebral bones and spinal joints, and/or relieve pressure which has resulted in pain and potential damage to the spinal nerves. Minimally invasive spine surgery is often applicable in conditions, such as degenerated or herniated discs, spinal instability, bone spurs, spine fractures and spinal stenosis.

Benefits of MISS include:

  • Decreased pain
  • Improved function
  • Less blood loss
  • Less need for pain medication
  • Less scarring
  • Quicker recovery from surgery
  • Reduced risk of infection
  • Shorter surgical time
  • The possibility of local anesthesia for certain same-day procedures

The Society for Minimally Invasive Spine Surgery (SMISS) has put together some helpful questions to ask your surgeon if you are considering minimally invasive spine surgery:

  • What percent of your practice involves minimally invasive surgery?
  • How long have you been doing minimally invasive surgery?
  • How many minimally invasive surgery procedures have you performed in the last six months?
  • What training have you had in minimally invasive surgery?
  • Do you present your work on minimally invasive surgery in any scientific context (i.e., journal articles or meetings)?
  • Are you board certified by either the American Board of Orthopaedic Surgeons ( or the American Board of Neurological Surgery (*

Spine Specialists

At Northeast Orthopedics and Sports Medicine (NEOSM), we are prepared to address these and any other questions or concerns you may have. It is part of our mission to educate consumers as fully as possible. Contact us at any one of our 10 locations with inquiries regarding any and all spine issues.

*Nationally recognized board certification entities are listed with the American Board of Medical Specialties ( The ABOS and ABNS are currently the only recognized boards for spinal surgery.