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Steven Rapp, MD
St. Joseph Mercy Oakland

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THE FACTS ABOUT Minimally Invasive Spine Instrumentation Reduces Trauma, Pain


The spine is made up of a complex system of bones, ligaments,
tendons, muscles, and nerves. When a problem develops in this
area, individuals can experience severe pain—along with a host of
muscular and neurological problems.

Podcast Posted: 10/27/2008
“One of the most common causes of chronic back pain is lumbar
spinal stenosis, a condition marked by a narrowing of the spinal
cord which results in pinching of the surrounding nerves,” says
Steven Rapp, MD, chair, Department of Neurosurgery at SJMO.
“Patients with this condition often suffer with persistent lower
back pain, and, in advanced cases, are faced with limping and other
mobility challenges.”

Until recently, surgeons performed traditional, or open, spine
surgery to correct this disorder. The procedure involves making a
large incision up and down the middle of the back and detaching
the back muscles to access the spine. As a result, significant postoperative
pain and blood loss often followed.

Today, surgeons are turning to a new, minimally invasive surgical
technique that uses a thin telescope-like instrument called an
endoscope (with a miniature video camera and light attached),
which is inserted through a small incision in the body. The tiny
video camera projects large-scale images of the spine onto a video
screen, to provide the surgeon with a view inside the body.

“Minimally invasive techniques, using newly designed
instrumentation, are changing the face of how we perform spinal
surgery,” says Dr. Rapp. “We’re helping patients with degenerative
disk disease, spinal stenosis and scoliosis return to active lifestyles
much faster than they could with traditional methods.”

Among its many applications, minimally invasive spine surgery also
allows surgeons to remove hard to reach spinal tumors through
tiny incisions. Additionally, a variety of spinal instrumentation, such
as screws and rods, can be placed to help stabilize and fuse the

Unlike traditional spine surgery, minimally invasive techniques
eliminate the need to move, or retract, the major muscles in the
back. “These advanced technologies allow us to make very small
incisions, about three quarters of an inch long, which minimize
trauma to the muscular system,” says Dr. Rapp. Other advantages
of minimally invasive techniques include shorter hospital stays,
reduced pain, minimal blood loss, less anesthesia, and faster
recovery times.

There are many treatments for spine conditions. Non-surgical
treatments include rest, ice or heat, medication, steroid injections,
exercise, and physical therapy. Minimally invasive spine surgery is
not recommended for everyone. Please consult your physician to
determine whether it may be right for you.


Stroke is a Leading Cause of Death and Disability
Yasmeen Ahmad, MD
Posted: 04/06/2009
Spine Instrumentation
Paul Croissant, MD
Posted: 08/10/2007
Brain Tumors
Paul Croissant, MD
Posted: 12/03/2007
Degenerative Disc Disease
Todd Nida, MD
Posted: 08/10/2007
Chronic Pain Management Restores Patients' Lives
Lawrence Rapp, MD
Posted: 04/20/2009
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