Minimally Invasive Spine Surgery (MISS) in Delhi

Minimally Invasive Spine Surgery (MISS) represents a revolutionary approach to treating various spine conditions through small incisions, specialised instruments, and advanced imaging technology. Unlike traditional open spine surgery, MISS techniques result in less muscle damage, reduced blood loss, shorter hospital stays, and faster recovery.

MISS procedures can effectively treat many spine conditions, including herniated discs, spinal stenosis, degenerative disc disease, spinal instability, and certain spinal deformities, offering patients excellent outcomes with minimal disruption to surrounding tissues.

Dr. Vikas Gupta, a senior consultant neurosurgeon and neurointerventionalist, specialises in minimally invasive spine surgery in Delhi, providing patients with advanced surgical options using microscopic and endoscopic techniques at Kailash Deepak Hospital, Karkardooma.

What Makes Surgery “Minimally Invasive”?

Minimally invasive spine surgery differs from traditional approaches in several key ways.

Key Characteristics

• Smaller incisions: Typically 1-3 cm compared to 10-15 cm in open surgery
• Muscle preservation: Muscles are dilated or separated rather than cut
• Advanced visualisation: Use of microscopes, endoscopes, and fluoroscopy
• Specialised instruments: Tubular retractors and purpose-designed tools
• Real-time imaging: Intraoperative X-ray or navigation guidance
• Reduced tissue trauma: Minimal disruption to healthy structures

Benefits Over Traditional Surgery

• Less post-operative pain
• Reduced blood loss
• Lower infection risk
• Shorter hospital stay
• Faster recovery and return to activities
• Smaller scars
• Reduced need for post-operative pain medication
• Lower risk of muscle damage and weakness

Conditions Treated with MISS

Minimally invasive techniques can address a wide range of spine conditions.

Disc-Related Conditions

• Herniated disc (slipped disc)
• Bulging disc
• Degenerative disc disease
• Disc protrusion causing nerve compression

Spinal Canal Narrowing

• Lumbar spinal stenosis
• Cervical spinal stenosis
• Foraminal stenosis (nerve exit narrowing)

Spinal Instability

• Spondylolisthesis (vertebral slippage)
• Degenerative spondylolisthesis
• Spinal instability requiring fusion

Nerve Compression

• Sciatica
• Radiculopathy (pinched nerve)
• Cauda equina syndrome (in emergency situations)

Spinal Deformity

• Selected cases of scoliosis
• Kyphosis correction

Other Conditions

• Spinal fractures (traumatic or osteoporotic)
• Certain spinal tumours
• Facet joint arthritis
• Synovial cysts

Dr. Vikas Gupta evaluates each patient to determine if minimally invasive techniques are suitable for their specific condition.

Types of Minimally Invasive Spine Procedures

Microdiscectomy

Removal of herniated disc material compressing spinal nerves through a small incision using a microscope. Most common MISS procedure for herniated discs.

Endoscopic Discectomy

Disc herniation treatment using an endoscope (small camera) through an even smaller incision, often performed as day surgery.

Minimally Invasive Decompression

Removal of bone and ligament causing spinal stenosis to relieve nerve pressure whilst preserving spinal stability.

Minimally Invasive Spinal Fusion (MISS Fusion)

Joining two or more vertebrae using screws and rods through small incisions for conditions requiring stabilisation, such as spondylolisthesis or instability.

Minimally Invasive TLIF (Transforaminal Lumbar Interbody Fusion)

Advanced fusion technique accessing the spine from the side, removing the disc and inserting a cage to maintain disc height whilst achieving fusion.

Percutaneous Pedicle Screw Fixation

Placement of stabilising screws through tiny skin punctures using X-ray guidance, often combined with other MISS procedures.

Endoscopic Foraminotomy

Enlarging the neural foramen (nerve exit passage) using endoscopic techniques to relieve nerve compression.

Kyphoplasty / Vertebroplasty

Minimally invasive treatment for spinal compression fractures, involving the injection of bone cement to stabilise fractured vertebrae.

Minimally Invasive Laminectomy

Removal of the lamina (back portion of the vertebra) to create space for compressed nerves.

Dr Vikas Gupta selects the most appropriate MISS technique based on individual patient anatomy, pathology, and clinical presentation.

Diagnostic Evaluation Before MISS in Delhi

Comprehensive assessment ensures appropriate patient selection and surgical planning.

Clinical Assessment

• Detailed medical history
• Comprehensive neurological examination
• Assessment of pain patterns and functional limitations
• Evaluation of previous treatments and their outcomes

Imaging Studies

• MRI Spine: Gold standard for visualising disc herniations, nerve compression, and soft tissue pathology
• CT Scan: Detailed bone structure assessment
• X-rays (Dynamic): Standing and flexion-extension views to assess spinal alignment and instability
• Myelography: Special imaging for complex cases
• CT Myelogram: Combined CT and contrast study for detailed nerve root visualisation

Additional Tests

• Nerve conduction studies and EMG if nerve damage is suspected
• Bone density scan (DEXA) for fusion planning in osteoporotic patients
• Blood tests for fitness assessment

Conservative Treatment Trial

Most patients undergo conservative management (physiotherapy, medications, injections) for 6-8 weeks before surgery is considered, unless a neurological emergency exists.

The MISS Surgical Procedure in Delhi

Pre-Operative Preparation

• Admission on day of surgery or previous evening
• Pre-anaesthetic assessment
• Consent process with detailed discussion
• Marking of surgical site

During Surgery

• Anaesthesia: General anaesthesia is administered; the patient is positioned appropriately (prone for lumbar procedures, supine or lateral for cervical).
• Small Incision: A 1–3 cm incision is made at the appropriate level, using fluoroscopy (real-time X-ray) for precise localisation.
• Muscle Dilation: Sequential dilators gently separate muscles rather than cutting them, creating a narrow working channel.
• Tubular Retractor Placement: A cylindrical tube is positioned to maintain the corridor and protect surrounding tissues.
• Microscopic or Endoscopic Visualisation: A high-powered microscope or endoscope provides a magnified view of the surgical field.
• Surgical Procedure: The specific procedure (discectomy, decompression, fusion) is performed using specialised instruments designed for minimally invasive approaches.
• Fluoroscopic Guidance: Continuous X-ray imaging ensures accuracy, especially when placing screws or implants.
• Closure: After achieving the surgical goal, the tubular retractor is removed. The small incision is closed with absorbable sutures.

Duration

Procedure time varies: 45–90 minutes for simple discectomy, 2-4 hours for fusion procedures.

Recovery After Minimally Invasive Spine Surgery in Delhi

Recovery is typically faster than traditional open surgery.

Immediate Post-Operative Period

• Recovery room observation for 2-4 hours
• Pain management with oral or intravenous medications
• Early mobilisation encouraged
• Walking begins within a few hours for most procedures

Hospital Stay

• Simple procedures (discectomy): 24-48 hours or same-day discharge
• Fusion procedures: 2-4 days
• Discharge once mobilising comfortably and pain controlled

First Week at Home

• Gradual increase in walking distance
• Avoid prolonged sitting initially
• No bending, lifting (>2-3 kg), or twisting
• Wound care and keeping the incision dry
• Continue prescribed medications

Weeks 2-6

• Progressively increase activities
• Begin gentle stretching exercises
• Physiotherapy as recommended
• Avoid heavy lifting and strenuous activities
• Follow-up appointments for wound check and progress assessment

Months 2-3

• Gradual return to normal activities
• Strengthening exercises under physiotherapy guidance
• Most patients resume full activities by 6-12 weeks

Return to Work

• Sedentary work: 2-3 weeks
• Light manual work: 4-6 weeks
• Heavy manual labour: 8-12 weeks
• Individual guidance provided based on occupation

Driving

Typically resumed after 2-4 weeks when comfortable and not taking strong pain medications.

Technology and Equipment Used in MISS

Surgical Microscope

High-powered magnification (6–40x) with excellent illumination for precise tissue identification and safe surgery.

Endoscopic Systems

Small cameras providing wide-angle visualisation through tiny incisions.

Tubular Retractor Systems

Expandable or fixed tubes that create and maintain surgical corridors through muscles.

Intraoperative Imaging

• C-arm fluoroscopy for real-time X-ray guidance
• O-arm or intraoperative CT for complex cases
• Navigation systems for enhanced precision

Specialised Instruments

• Angled curettes and disc forceps
• Radiofrequency probes for haemostasis
• Endoscopic bone removal tools
• Percutaneous screw insertion systems

Kailash Deepak Hospital is equipped with modern MISS technology, enabling Dr Vikas Gupta to perform advanced procedures safely.

MISS vs Traditional Open Surgery: Comparison

Incision Size

• MISS: 1–3 cm
• Traditional: 10–15 cm

Muscle Damage

• MISS: Minimal (muscles dilated)
• Traditional: Significant (muscles cut and retracted)

Blood Loss

• MISS: 25–100 ml
• Traditional: 200–500 ml

Hospital Stay

• MISS: 1–2 days
• Traditional: 4–7 days

Recovery Time

• MISS: 2–6 weeks
• Traditional: 8–12 weeks

Post-Operative Pain

• MISS: Significantly less
• Traditional: More severe, longer duration

Return to Work

• MISS: 2–6 weeks
• Traditional: 6–12 weeks

Complication Rate

• MISS: Lower
• Traditional: Higher

Cost of minimally invasive spine surgery in Delhi

The average cost of minimally invasive spine surgery in Delhi ranges from ₹4,30,000 to ₹5,00,000, depending on several factors:

• Type and complexity of the MISS procedure
• Number of spinal levels treated
• Need for instrumentation (screws, cages, rods)
• Duration of surgery
• Hospital stay duration
• Type of implants used
• Pre-operative investigations
• Post-operative care and physiotherapy

A transparent cost estimate is provided during consultation. Patients should enquire about insurance coverage and available payment options.

Why Choose Dr. Vikas Gupta for MISS in Delhi?

• Specialised training and extensive experience in minimally invasive spine techniques
• Expertise in both microscopic and endoscopic approaches
• Access to advanced MISS equipment and technology
• Patient-centred approach focusing on optimal outcomes
• Comprehensive pre-operative assessment and surgical planning
• Dedicated post-operative care and rehabilitation guidance
• Ethical, evidence-based treatment recommendations

Patients trust Dr. Gupta for expert minimally invasive spine surgery with compassionate, personalised care.

Book a Consultation for Minimally Invasive Spine Surgery in Delhi

If you are experiencing persistent back or leg pain, neck pain, or neurological symptoms due to spine conditions, you may consult Dr. Vikas Gupta to explore whether minimally invasive spine surgery is appropriate for you.

During Your Consultation

• Comprehensive clinical and neurological examination
• Detailed review of imaging studies (MRI, X-rays, CT scans)
• Discussion of diagnosis and severity
• Explanation of treatment options, including MISS techniques
• Clear information about expected outcomes and recovery
• Answers to all your questions and concerns
• Transparent discussion regarding treatment costs and hospital stay

Early consultation can prevent progression and improve outcomes. Book your appointment today for expert minimally invasive spine care in Delhi.