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By Cuellar Spine

What is minimally-invasive spine surgery?
Also referred to as MIS spine surgery or MISS,
this term has been used a lot recently, and not always
appropriately. Some surgeons refer to any surgery in which
they make a smaller than traditional incision as MIS surgery.
However, I believe that the true distinction between
traditional and MIS spine surgery is the amount of muscle
dissection and muscle damage that the surgeon makes during
the surgery. This philosophy I attribute to my mentor Dr.
Anand, a pioneer in MIS spine surgery.

Muscle-sparing MIS spine surgery
Many of the operations that I perform as a spine
surgeon must be performed while keeping a few major goals
in mind to make you, the patient, feel better:
Nerve or spinal cord decompression
Spinal stability
Motion preservation at the treated level (s) if at all possible
If I can achieve these goals with the surgery, you will feel
etter. No let’s talk a out ho e a tl e a a hie e these
surgical goals together. Depending on what spinal disorder
you have, we can most likely achieve these goals using a
variety of different surgical approaches or techniques. This is
where the true art of spinal surgery comes into place – the
learned techniques and preferences that I as a surgeon bring
to the table.

• For example, let’s sa ou ha e a er i al disk herniation at
two levels. These disk herniations are
1. Pinching your spinal nerves causing shoulder or arm pain
2. Compressing the spinal cord, causing you to have trouble
3. Causing neck pain
Once we have exhausted all non-surgical treatments such as
physical therapy and anti-inflammatory medications and we
decide together that spine surgery is your best option, we
can discuss various surgical techniques to treat your
symptomatic disk herniations. We could decide to try a
posterior cervical foraminotomy, which is technically an MIS
surgery, to relieve pressure on the pinched nerves.

Or we could perform a two-level anterior cervical
diskectomy and fusion (ACDF). Or we could choose to perform
a two-level artificial disk replacement. Technically, the
foraminotomy ight e o sidered to e ore of a MIS
procedure than an ACDF or disk replacement. However, the
foraminotomy requires disrupting the neck musculature to
obtain access. A two-level disk replacement might not sound
like a minimally-invasive procedure, but we can do it through
a small incision in the front of the neck that does not damage
any of the neck muscles.
This philosophy can be applied to various surgical
treatments of the spine, such as posterior spinal fusion using
percutaneous MIS techniques or lateral interbody fusions, etc.

• Contact us:
Cuellar Spine
450 N. Roxbury Drive
3rd Floor
Beverly Hills, CA 90210
Phone: (310) 803-9407

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