What is minimally invasive spine surgery?

Experienced orthopedic surgeons will provide conservative treatment options before undergoing spinal surgery. These can include medications, injections, steroids, biologics, and physical therapy to name a few.  However, some back conditions are progressive and require surgery.

Years ago, open surgery was the only option for treating spinal disorders that required procedures. While it’s still critical for some spinal disorders, open surgery can be invasive and need longer healing times. Nowadays, minimally invasive techniques can be used in place of open surgery for numerous spinal conditions. A minimally invasive approach requires a small incision and utilizes microscopic techniques.  The smaller incision and ability to work through the spinal area with minimal disruption to the muscles allows for quicker healing, less pain, and faster return of function.  

Minimally invasive spine surgery (MISS) can often be performed under local anesthesia, alleviating the risk of complications from general anesthesia. 

Numerous spinal conditions can be treated with minimally invasive spinal surgery. The following are a few examples:

  • Degenerative disc disease
  • Herniated disc
  • Lumbar spinal stenosis
  • Spinal tumors
  • Vertebral compression fractures

Why might I need minimally invasive spine surgery? 

If conservative treatment methods are not helping or no longer minimizing your pain, or if your mobility and range of motion or stability are jeopardized, surgical interventions are recommended to reduce and alleviate your back or spinal disorder.

While acute back pain doesn’t require surgery, if you have pain that does not subside or has gotten worse and interferes with your daily living, that is a key indicator of needing surgery, as is weakness in your spine, legs, hips, arms, or difficulty walking. 

If you have bowel or bladder incontinence due to your spinal condition, a fever with back pain (which can be a sign of infection), or tumors on your spine, then spinal surgery is usually the recommended procedure for an optimal outcome and recovery of function.

With decades of experience, at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine all of our surgeons are board-certified and fellowship-trained. We offer you the best treatment options and care.

At Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, we take our time with each patient to listen and present options that are customized to their specific needs.

We provide excellent medical care in a warm, caring, comfortable environment, where patients are treated efficiently, effectively, and as if they were the only patient—You will be in the hands of experienced surgeons. Let us get you back in your game.


How do I prepare for minimally invasive spine surgery?

Before your surgery, you will be referred for diagnostic imaging, which may include and MRI, x-rays and/or CT scan.  It’s imperative to discuss any and all medications and supplements that you take with your surgeon before your procedure.  Some medications or supplements may need to be stopped several days or weeks prior to your MISS due to bleeding disorders and other contraindications.

Antibiotics will be prescribed before and for a short time after your surgery.  

If you smoke or drink alcohol on a regular basis, it’s imperative that you stop before your surgery, and minimize or alleviate these substances after your surgery for less complications and to provide optimal healing and recovery.

If you exercise, staying active before your procedure can help to shorten your recovery time. After your procedure a post-operative plan will be provided for physical therapy and at home stretching and strengthening exercises if appropriate.

What happens during minimally invasive spine surgery? 

With open spinal surgery, a long vertical incision is made to access the spinal column. The incision can be on the back, abdomen or chest depending on the area. With Minimally invasive spinal surgery, the incision is smaller. Most times one or two incisions are all that are needed for MISS.

A fluoroscope provides moving X-rays of your spine and allows the surgeon to decide which are best for the incision, as well as real time images of your spine during the surgery.  An instrument known as a microscope, allows the surgeon and his team a view on a monitor in the operating room.  Tiny instruments can be passed through the incision or guided through the nearby tubular retractors.

A tubular retractor helps to minimize any disruption to the nerves and muscles in the spine. This retractor is tube-shaped, hence the name, and provides a means to reach the area of the spine that is damaged, as well as the transportation of the tiny instrumentation.  

After your MISS procedure is finished, the incision(s) are closed with stitches, glue, or staples., and a small bandage is applied.

What happens after minimally invasive spine surgery? 

Many MISS procedures are done in an outpatient setting. If this is the case, you will be discharged a few hours after your surgery. This allows the medical team time to evaluate your initial recovery and make sure you don’t have any issues or reactions. 

A designated driver will need to take you home. You will need to have this preplanned before your surgery.  Over-the-counter pain medications or prescription drugs can be taken for any discomfort, but many patients don’t feel the need to take anything.  It all depends on the severity of your surgery and condition.  

Bleeding should not be an issue, but there may be a small amount of bleeding immediately after your surgery.  You should not do anything strenuous and try to limit your movements for the allotted time period your orthopedic surgeon designates for you. You may be asked to wear a stabilizing back brace.

Physical therapy provides strategic muscle strengthening, stretching, and stabilization that is specific to each patient. Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine has a group of elite physical therapists on site, making our treatment patient care and communication convenient for patients and ideal for our practitioners.

Focusing On You

As healthcare is ever changing, Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, is doing things differently…

  • About Christopher R. Sforzo, M.D. Christopher R. Sforzo, M.D. is a board certified orthopedic surgeon and fellowship trained in hand and upper extremity surgery. He provides expert care in the treatment of problems involving the shoulder, arm, elbow, forearm, wrist and hand. He performs many procedures using mini
  • About Christopher L. Dillingham, M.D. Christopher L. Dillingham, M.D. is a board certified orthopedic surgeon and fellowship trained in hand, shoulder, and arm surgery. He specializes in the treatment of problems with rotator cuff disorders, carpal tunnel syndrome and nerve injury, joint replacement, arthritis sur
  • About Charles E. Stewart, M.D. Charles E. Stewart M.D. is a board-certified, Johns Hopkins fellowship-trained orthopedic surgeon specializing in adult complex reconstruction of the lower extremity.  His specialties include lower extremity sports injuries, meniscal injuries, ACL reconstruction, partial knee replacement,
  • About Philip A. Meinhardt, M.D. Philip A. Meinhardt, M.D. is a board certified orthopedic surgeon and fellowship trained spine surgeon. He specializes in adult spinal surgeries including reconstruction of spinal deformities, minimally invasive/microscopic spinal procedures, decompression, spinal instrumentation, fusion



After tearing my rotator cuff, not only was I experiencing pain but my quality of life was diminished. Playing golf and working out were painful rather than enjoyable. Graci and I sought out Fellowship trained Dr. Christopher Sforzo and the team at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine. I was treated non-surgically and am now pain free, mobile and enjoying everything I did before.

- Dennis and Graci McGillicuddy

As avid golfers and tennis enthusiasts, our rotator cuff injuries left us in pain, and unable to enjoy our sport. In researching for the most qualified surgeons, we found that Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine not only had the highest level of training and experience, but they were also highly recommended by friends and associates who had excellent results. We, too, had outstanding…

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I was visiting the area looking at property and considering a full time re-location from Minnesota when I was in a traffic accident. The result was a very painful shoulder injury that would ultimately require bilateral RTC repairs. I was unable to undertake regular day-to-day activities or participate in my favorite sport – tennis. It was essential that I choose a shoulder specialist that could quickly set…

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Over the years we had seen several orthopedists in town but were never impressed. They seemed to lack knowledge or compassion or both. Then when Liza was in high school, she went to Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine for a minor sports injury. They not only diagnosed her somewhat obscure problem, but explained things in a way that she understood without being patronizing…

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As a very busy business owner in Sarasota, having not one, but two, massive rotator cuff tears had a debilitating effect on both my personal and professional life. From my first consultation with Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, I knew I was in good hands. The surgeons are board-certified and fellowship-trained, which gave me the confidence in achieving a successful outcome. More importantly,…

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