Due to recent advances in technique and equipment, there are many spinal
disorders that can now be corrected with minimally invasive spine surgery.
Dr. Richard Lee, a spine surgeon at NOI, is now performing some minimally invasive spine
surgeries on an outpatient basis at the Orthopedic Surgery Center of Orange
County, located in the same building as NOI in Newport Beach. Dr. Lee
took some time to answer a few questions about minimally invasive spine surgery.
What is minimally invasive spine surgery?
Dr. Lee: “Minimally invasive spinal surgery” describes a set of operative
techniques that represents a continuum in the development of modern spinal
surgery techniques. The advent of newer tools for use in spinal surgery
allows surgeons to access the spine and perform procedures with lesser
degrees of anatomy dissection and tissue disruption. The intended goal
with development of minimally invasive spinal surgery techniques is to
promote faster recovery after surgery through less dissection of tissue.
How big is the typical incision?
Dr. Lee: As tools and techniques have evolved, the sizes of the operative incisions
required for safe surgery of the spine have decreased in length in many
types of operations. The main factors in determining the necessary length
of an incision are the type of surgery and the size of the patient. For
example, a procedure to correct a large scoliosis curvature affecting
many levels of the spine would require a larger surgical exposure than
an operation to treat a single level disc herniation. A one level disc
herniation surgery can often be performed through a one inch incision
when performed on an average sized patient.
What are the advantages of minimally invasive surgery techniques?
Dr. Lee: Developmental efforts in minimally invasive spinal surgery techniques
are focused on attempting to disrupt less structurally important body
tissues such that a patient can recover faster after surgery. Some disruption
of body tissue will necessarily occur whenever any surgical procedure
is performed on the human body. When less disruptive dissection is performed,
a patient can potentially return to function quicker as less healing is
required from the surgical dissection process itself.
What spinal conditions can be treated with minimally invasive surgery?
Dr. Lee: Many of the common spinal disorders requiring surgery can now be treated
with minimally invasive surgical techniques. This includes disc herniations,
spinal stenosis, spondylolisthesis, degenerative spinal conditions, spinal
fractures, and even some types of scoliosis.
How long is the stay after surgery?
Dr. Lee: Some minor spinal disorders such as disc herniations can be treated with
outpatient surgery. Many patients are able to be discharged after an overnight
stay even with spinal fusion surgery. In general, larger scale surgeries
will require longer hospital stays.
Typically, how long is the recovery process?
Dr. Lee: Recovering after a spinal surgery is most affected by the overall physical
condition of the patient at the time of surgery. Healthier patients will
generally recover more quickly than those with medical comorbidities.
Spinal surgeries performed with the latest minimally invasive techniques
help patients recover function and mobility faster through less extensive
dissection of body tissues.
Outpatient Minimally Invasive Surgery
For the healthier patients, minimally invasive spine surgery can be performed
safely in a surgical center that is equipped for spine. Dr. Lee performs
minimally invasive spine procedures at Orthopedic Surgery Center of Orange
County (OSCOC), which is located in the same building as Newport Orthopedic
Institute in Newport Beach. OSCOC is an ambulatory surgery center that
is affiliated with Hoag Hospital and Hoag Orthopedic Institute. Being
an orthopedic center, the primary focus for the team is the needs of the
orthopedic patient and family. The level of care and ratio of nurses to
patient is high at 1RN for every 1-2 patients. In addition, all anesthesia
care is provided by the anesthesia group at Hoag Hospital. The Board certified
physicians are kept up to date with safe care and best practice for anesthesia
and pain management.
Minimally invasive spine surgery at OSCOC can provide a unique value to
patients. OSCOC is a free standing surgery center that does not access
hospital rates. OSCOC is currently in-network/contracted with all major
payers in California and has been since 2000. Patients can access the
contracted rates for all services through their insurance benefits. OSCOC’s
high quality outcomes and high patient satisfaction scores, along with
the preferred pricing makes it a high value center for patients. We can
provide information about a patients out of pocket costs prior to surgery.
Also, being well versed in the costs, OSCOC and the physicians can offer
competitive cash rates that are bundled with the facility costs, anesthesia
care, surgeon fees and more. This provides transparency and peace of mind
for the patients when considering minimally invasive spine surgery.
While most minimally invasive spine procedures do not require overnight
stay in a facility, there are certain times when this is a good option.
OSCOC has private patient rooms for 23 hour recovery care that are staffed
by 2 highly trained nurses, the ratio of nurse to patient is 2RN for every
1-3 patients. This is available when pre booked and needed for specific
procedures. In addition, OSCOC has a Medical Travel program that has been
in place since 2008. We have protocols and experienced staff to assist
patients who travel from out of Orange County.
For more information on Dr. Lee and minimally invasive spine surgery, please