August 2019 Edition. Volume XIX

The premise of minimally invasive (“band-aid” per it’s M2H2H promotion) surgery is naturally attractive to all in need of surgical intervention.  The validity of this concept for the individual patient does however require two things:

A well-informed patient.
A discriminating and ethical surgeon.

 When these are joined together the resultcan be a piece of good fortune for the patient.

Case Example:  R.B., a 84 year old female with a degenerative spondylolisthesis at the lumbar 4-5 level became suddenly incapacitated by right thigh pain.  MRI showed a herniated disc fragment extruded laterally into the intervertebral foramen at the level of the listhesis.  Percutaneous AMD plucked out the fragment, relieved the patient’s pain, and returned her to comfort.  She required no further spine care during her remaining 4 years of life.

On the other hand significant misrepresentation exists in the area of minimally invasive surgery.  This is particularly true in the emergence of “Pain Management Center” procedure mills.  Because the term “laser” has become a “buzz word” endoscopic spinal laser procedures have become particularly notorious in the excessive charge and unnecessary surgery departments.  Multiple procedures (each costing over 5 figures) have been reported being performed on the same patient.

The minimally invasive area of spine care is inherently attractive to the consumer, as is a bright light to a moth.  The patient, however, needs to be more discriminating. When all is said and done a microsurgical discectomy or microdiscectomy remains the over-all, well-establishes standard of care.


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