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Future of Spinal Care: From Open Surgery To Less Invasive Methods

Modern spinal care gives patients the choice of undergoing surgery with smaller incisions and faster healing. Traditionally, open surgery has been the go-to method for treating spine conditions. However, in recent years, minimally invasive spine surgery (MISS) and endoscopic spine surgery have emerged, providing less invasive alternatives with potentially quicker recovery times and fewer complications. 

In this article, we’ll explore the differences between conventional open surgery and minimally invasive methods so you can be better informed in deciding your spinal health.

What is spine surgery?

Spine surgery is a surgical treatment that addresses conditions affecting the spinal column. These conditions can include herniated discs, spinal stenosis, degenerative disc disease, spinal deformities, and spinal tumours.

Conventional open surgery

Conventional open surgery involves a large incision, muscle dissection, and tissue retraction to access the affected area of the spine. While effective, this approach can lead to significant blood loss, muscle damage, and longer recovery times. Until recent years, open surgery was mostly considered for treating spinal conditions.


Preparation for open spine surgery typically involves pre-operative testing, such as blood work and scans, to check the patient’s overall health and the extent of the spinal condition. You may also need to discontinue certain medications and follow specific dietary guidelines before surgery.


During the procedure, the surgeon makes a sizable incision along the spine to access the affected area. Muscles and tissues are then moved aside to expose the spine, allowing the surgeon to perform the necessary repairs or corrections. Upon completion of surgery, the incision is closed with sutures or staples.


Recovery from open spine surgery can be lengthy, often requiring weeks to months of rehabilitation. You may experience significant pain and discomfort initially, and physical therapy is usually necessary to regain strength and mobility.

Minimally Invasive Spine Surgery (MISS)

Minimally invasive spine surgery (MISS) is a recent advancement in surgical techniques. It gives patients a less invasive alternative to open surgery. This approach employs specialised instruments and imaging technology to reach the spine through smaller incisions, minimising damage to surrounding tissues and muscles. 

MISS techniques may include decompression, fusion, and stabilisation procedures depending on the patient’s condition.


Preparation for MISS is similar to open surgery, with pre-operative testing and medical evaluation conducted to ensure the patient’s suitability for the procedure. However, due to the less invasive nature of MISS, patients may experience shorter hospital stays and faster recovery times.


During MISS, tiny incisions are made near the spine, through which specialised instruments and a small camera (endoscope) are inserted. The camera provides real-time surgical site visualisation, allowing the surgeon to perform precise manoeuvres with minimal tissue disruption. 


One key advantage of MISS is its shorter recovery time than open surgery. Smaller incisions and less tissue trauma mean that patients experience less post-operative pain and can resume normal activities sooner. However, physical therapy may still be required to optimise recovery and improve strength and mobility.

Endoscopic Spine Surgery

Endoscopic spine surgery is an less invasive alternative to MISS. This approach utilises an endoscope—a thin, flexible tube equipped with a camera and surgical instruments—to access the spine through tiny incisions. 

Endoscopic techniques are particularly well-suited for procedures such as single or multiple levels discectomy, spinal decompression foraminotomy, and spinal fusion. In our centre, we extended the indications to cervical and thoracic decompression as well.


Preparation for endoscopic spine surgery is similar to other minimally invasive procedures, with pre-operative testing and medical evaluation conducted to ensure patient suitability. However, due to the highly specialised nature of endoscopic surgery, patients may require additional imaging studies to plan the procedure precisely.


During endoscopic spine surgery, the endoscope is inserted through small incisions near the spine, providing a clear view of the surgical site. Guided by real-time imaging feedback, the surgeon performs the necessary repairs or corrections through the endoscope, using micro instruments like lasers, radiofrequency probes or graspers.


The recovery process following endoscopic spine surgery is typically faster and less painful than traditional open surgery. Patients can resume normal activities within a shorter time frame with smaller incisions and minimal tissue disruption. In our centre, we perform most of our endoscopic spine surgery as a day-surgery procedure with patients having a short stay in the hospital. Physical therapy may be recommended to optimise outcomes and facilitate long-term spine health.

Which Procedure is Better for You?

Depending on the diagnosis and the patient’s overall health, MISS and endoscopic surgery are usually preferred by our patients over open surgery due to:

  • Smaller incisions
  • Preservation of healthy tissues
  • Less blood loss
  • Reduced pain and discomfort
  • Faster recovery
  • Improved cosmetic outcome
  • Lower risk of complications

Many patients can benefit from MISS and endoscopic spine surgery, including:

  1. Patients with herniated discs: MISS and endoscopic surgery can relieve pressure on the spinal nerves, alleviate pain, and improve mobility with minimal disruption to surrounding tissues.
  2. Individuals with spinal stenosis: MISS and endoscopic surgery offer targeted decompression of the spinal canal, relieving symptoms associated with spinal stenosis, such as numbness, tingling, and weakness in the extremities.
  3. Those with degenerative disc disease: Minimally invasive procedures address degenerative disc disease by removing damaged disc tissue, stabilising the spine, and promoting healing. 
  4. Patients requiring spinal fusion: Smaller incisions, reduced blood loss, and faster recovery times can benefit patients requiring spinal fusion to stabilise the spine and alleviate pain caused by conditions like spondylolisthesis or spinal fractures.

Despite the many advantages of undergoing MISS, our centre still frequently performs open surgery as necessary for complex cases based on the surgeon’s assessment. In instances where the spinal condition is particularly severe or involves extensive spinal deformities, open surgery may provide the best chance for achieving optimal outcomes and long-term stability.

Minimally Invasive or Endoscopic Spine Surgery in Singapore

Less invasive surgical techniques, such as MISS and endoscopic spine surgery, allow for faster recovery times, reduced complications, and improved patient outcomes. If you’re considering spine surgery for a spinal condition, we encourage you to explore these treatment options and consult with a qualified spine specialist to determine the best approach for your condition.

At Achieve Spine & Orthopaedic Centre, we specialise in minimally invasive and endoscopic spine surgery techniques, offering patients care with a focus on optimal outcomes and patient satisfaction. Dr Wu is dedicated to providing personalised treatment plans according to each patient’s needs, ensuring the best possible results with minimal disruption to daily life.

Book a consultation to learn more about MISS and endoscopic surgery.

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