Neurosurgery Dr. Stoforou


Minimally Invasive Surgery MIS and Minimally Invasive Spine Surgery MISS

The aim is to decompress the nervous structures that suffer (nerves, spinal cord) and to stabilize the vertebral bodies and joints, if necessary, with the least possible trauma to healthy tissues. In contrast to open spinal surgery, minimally invasive surgical approaches are faster, safer and require less recovery time.

Key Benefits of minimally invasive surgery MIS and minimally invasive spine surgery MISS:

  • Smaller incision better aesthetic result
  • Less blood loss
  • Minimal or no incision in the muscles
  • Less risk of post-operative infection
  • Faster recovery and rehabilitation after surgery
  • Minimal post-operative drug delivery

In addition, some MIS surgeries are performed in Daytime Surgery (ODS) and are performed with local anesthesia.


* It is of course necessary to clarify that, as with open surgical procedures, in minimally invasive techniques in the spine, there is a possibility of complications, such as :

  • Side effects of the anesthetic
  • Unexpected blood loss
  • Local infections in the wound, irrespective of the size of the incision

* Also, there is always a small possibility that a minimally invasive method can not be completed, thus requiring either a second procedure or turning into open surgery.

Minimally invasive surgery MIS and minimally invasive spine surgery MISS and the list of diseases that can be treated:

  • Degenerated intertebral disc
  • Intertebral disc herniation
  • Lumbar stenosis
  • Scoliosis
  • Spinal cord infections
  • Vertebral instability
  • Spine fractures
  • Spinal column and spinal cord tumors

What do we mean when we say minimally invasive surgery MIS and minimally invasive spine surgery MISS?

Spinal nerves, vertebrae and invertebral discs are situated deeply under the skin inside our body, and any surgery to access them requires moving or cutting the muscles to prevent them from posing an obstacle to surgery. With minimal invasive techniques, muscle masses are displaced by progressive insertion through them of specific dilators. These expanders essentially do not cut muscle masses, but they dilate them to create a passage that will be used for the entry of surgical instruments and microscopic cameras that will provide a better view of the surgical field.

Various methods are used to minimize surgical trauma during minimally invasive spine surgery MISS, such as:

  • Transdermal discogel spine discoplasty MIS (Local anesthesia / drunkenness)
  • Transdermal application of radiofrequency to the spinal cord (Local anesthesia / drunkenness)
  • Insertion of a mesacanthian prosthesis for posterior dynamic spine fixation. (Local anesthesia / drunkenness)
  • Performing endoscopic microdiscectomy MIS surgery or endoscopic discectomy surgery through cylindrical dilators (General anesthesia)
  • Transdermal placement of rods and screws for fusion, i.e. immobilization and stabilization of the spine section in this way, in cases of instability (general anesthesia). During transdermal fusion, the screws and bars are placed transdermally, that is through small incisions of the skin and guided radiographically by guidewires they are placed at the desired point of the vertebral bodies. These screws have non-permanent extensions that come out of the skin and serve to facilitate the placement of the rods and their stabilization. At the end of the procedure they are removed.
  • Kyphoplasty and vertebroplasty spine surgery. They are indicated in spinal fractures without pressure on the spinal cord and therefore without neurological signs. In the kyphoplasty the physician introduces an expanding balloon to raise the lesioned vertebra, whereas in vertebral surgery the surgeon inserts acrylic cement into the vertebra for stabilization of the fracture.
  • Lateral spine accesses. In some cases, especially in the lumbar spine, its access from the side has an advantage in postoperative pain because of limited muscle wound. Access is made with the patient in an oblique position. Then the operation is again done using dilators reaching up to the vertebral bodies and invertebral disc, from the lateral side.
  • Thoracic access to the thoracic spine. These are used in some cases where it is necessary to access the thoracic spine through the thoracic cavity. With the use of thoracoscopy (a chest endoscope) it is possible to access the thoracic spine. It should be noted that the thoracoscopic method requires multiple holes in the chest wall so that the camera and the microtools can enter for the surgery.
  • Vertebral fixation without fusion
  • Rear elements (acanthoid processes, posterior mesangial junction)

    § Rear dynamic stabilization using pre-mesacanthoid prefix

  • Frontal part of spinal column (invertebral disc, vertebral bodies)
    § Minimally Invasive Lateral Interbody Fusion
    § Minimally invasive posterior lumbar interbody fusion (PLIF)
    § Minimally Invasive Transaminal Lumbar Interbody Fusion (TLIF)
    § Minimally Invasive Posterior Thoracic Fusion (Minimal Invasive Posterior Thoracic Fusion)