February 2020 Edition. Volume XX

There are many minimally invasive spine procedures being performed today.  Some, such as epidural steroid injections are often used with little appreciation or understanding of the patient’s real diagnosis (“shotgun therapy”) and sometimes with no understanding that the patient does not even have an anatomic epidural space (i.e. obliterated by prior spine surgery).  Most certainly, in the “physician do no harm” department ill-advised and ill-performed epidural steroid injections have created devastating lifelong problems for significant numbers of unsuspecting patients.

Other minimally invasive procedures such as percutaneous radio-frequency facet blocks (PRFFNB) which have benefited many over many decades are therapeutic, but destructive, in that they cauterize normal nerves to achieve their effect. The value of such a procedure is that the benefit to the patient outweighs the minimal risk.

LeafSkyBut50JPGMinimally invasive restorative spine care is a different approach to healing. It is intended to be as non-destructive as possible and to avoid initial as well as long-term harm to the patient.  Much of  this field of endeavor represents such advanced thinking that a good deal of it has not yet even entered into the clinical sphere.

Minimally invasive spine care is characterized by vertebroplasty,kyphoplasty, polymeric injections into degenerated discs and annulus repair technology.  Minimally invasive procedures often replace ill-advised major instrumented surgery being performed in patients with multilevel degenerative disease, often on a genomic basis.

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