Our Approach is Different

Spine surgery in our region has not changed much in the last 30-40 years while in other parts of the country, spine care has evolved.  This is certainly true in Washington State and Oregon where minimally invasive surgeries are not the norm.  In fact, the vast majority of spine surgeries for low back disease are still done in the same fashion as they were in the 1990’s or before.  A 1990 car is very different from one made in 2020 in terms of safety features and technology.  It is our belief that spine patients should benefit from modern care similarly to how the automotive industry has evolved.  

At Modern Spine, we strive to offer the least invasive options to patients that get them home faster and with less risk than traditional spine surgery.  This is accomplished by taking a minimally invasive approach to every patient and almost every condition.  In our practice, open surgery is an extreme rarity and minimally invasive approaches are the norm.  

Below we discuss the differences between traditional and minimally invasive spine surgery:



Traditional / Open Back Surgery

Traditional lumbar surgery also known as open lumbar surgery involves making a relatively large incision in the back, separating the muscles off the spine, and exposing the bones of the spine.  Through direct visualization through an open wound, bone is drilled away for decompression and in some cases instrumentation is placed.  The surgery usually entails significant risks with a relatively high chance of infection and transfusion due to the large surface area exposed.  Muscle trauma is common and can lead to permanent loss of muscle and muscle scarring.  This is the most common method of spine in the United States for the past several decades.

Most surgeons in this region perform open spinal surgery for most of the surgeries they perform.  If you are seeing another surgeon and they are not describing “tubular or endoscopic” spine surgery, you should seek a second opinion at Modern Spine before proceeding.  With a second opinion, we would be able to explain the differences and in many cases be able to offer a smaller, less invasive solution to even complex problems.

Minimally Invasive Back Surgery Surgery

This is a more modern form of lumbar surgery that involves making tiny incisions and being less disruptive to the spine and the muscles around it.  The technique is similar to how cameras are used to remove a gallbladder today instead of a large open cut.  The technology has been around since around the year 2000, but is has not been widely adopted.  Because the muscles are less harmed, patients generally mobilize quicker and go home faster than with open lumbar surgery. 

Minimally invasive techniques can be used for simple herniated disc removal and decompression or laminectomy surgery, and they can also be used for simple and complex spinal reconstructions. 

Confusingly, some surgeons will advertise minimally invasive spinal surgery but not actually offer that care for most of the conditions they treat.  If you are seeing another surgeon, you should ask them if the surgery is “open, mini-open, or traditional,” and if so, consider a second opinion with a truly minimally invasive surgical team.  

At Modern Spine, we can also perform even the most complex spinal operations through these smaller incisions.  Scoliosis, deformity, and even revisions can all be performed using minimally invasive techniques allowing patients to reduce their risk of transfusion, lower rates of infection, skip a stay in an ICU after surgery, and leave the hospital or surgery center more quickly.    

Conditions We Treat

Disc Herniation
Spinal Stenosis
Spinal Cord Compression
Nerve Root Compression
Radiculopathy / Leg Symptoms
Degenerative Disc Disease
Spinal Fracture
Deformity / Scoliosis / Kyphosis
Spinal Tumors
Spinal Infections
Revision Surgery
Sacroiliac Disease
Other Conditions

When to Consider Surgery

If you are experiencing increasing symptoms in your back or legs, it is adviseable to speak to your primary care physician, chiropractor, or rehab doctor to discuss conservative care options.  In many cases, non-surgical care is very effective at managing and resolving severe symptoms.  In fact, for disc herniations, about 80-90% of patients will improve without spinal surgery.

If the symptoms persist past 4-6 weeks for some conditions or 4-6 months for others, it is reasonable to seek consultation with a surgeon to discuss options.  Oftentimes, x-rays and an MRI are performed to assess the pathology before seeing a surgeon to identify areas of nerve compression or other pathology.  

Symptoms that you might experience are:

  • Back pain
  • Positional / activity related pain
  • Back stiffness
  • Muscle spasms
  • Leg / foot numbness
  • Leg / foot weakness
  • Leg / foot pain
  • Decline in ability to walk distances
  • Balance problems
  • Falls
  • Posture changes

If you are experiencing a rapid worsening of your symptoms, it might be in your best interest to seek Urgent Care or Emergency Room evaluation for rapid evaluation.  

Next Steps

If you are experiencing these back symptoms or have concerns, talk to your doctor or Contact Us at Modern Spine for a comprehensive evaluation.  We use focused patient surveys to assess to the degree of your disease, will review with you your MRI’s and x-rays personally, and will have a detailed discussion about the many options available.  You can research many of the options for your back here at Modern Spine in advance, and we will answer questions about your specific care options in detail.  

At Modern Spine, we believe in a no pressure environment when making decisions about surgery.  While the idea of neck surgery can be anxiety provoking, the surgeries are actually fairly safe, have relatively high success rates, and can be very helpful at returning patient’s back to their regular life before pain.  If you have concerns, contact us.  We offer initial consultations and second opinions regardless of whether you have had surgery before or not.