Minimally Invasive Spine Surgery (MISS) in Hyderabad
What is MISS?
Minimally invasive spine surgery (MISS) uses small incisions and tubular or endoscopic portals to reach the target safely while minimizing muscle disruption. In appropriate cases—such as endoscopic discectomy or foraminotomy—MISS can reduce early pain and shorten hospital stay compared with open approaches. The choice of technique is individualized; safety and long‑term outcomes remain the priority.
Who is a candidate?
- Herniated (slip) disc with radiating leg pain/sciatica not improving with conservative care
- Foraminal stenosis compressing the exiting nerve root
- Select recurrent herniated discs
- Some lumbar stenosis patterns amenable to endoscopic ULBD (unilateral approach to bilateral decompression)
When conservative therapy is likely to help, we continue non‑surgical care first. If imaging shows instability or deformity, other techniques may be advised instead of pure MISS.
Endoscopic vs microscopic: choosing the best approach
Endoscopic
A 6–8 mm portal with a high‑definition endoscope provides magnified visualization. Useful for targeted fragment removal and foraminal decompression while preserving stabilizers when feasible.
Microscopic
A small incision under an operating microscope. Preferred when broader exposure is safer or if endoscopic access is limited by anatomy.
If intraoperative visualization is inadequate for safety, we may convert to an alternative technique—this possibility is discussed during consent.
Step‑by‑step (example: endoscopic discectomy)
- Pre‑op evaluation: exam, MRI review, and anesthesia fitness
- Anesthesia and positioning
- 6–8 mm skin incision, working channel placement under imaging guidance
- Endoscopic visualization of the herniation; fragment removal to decompress the nerve
- Hemostasis and closure; early mobilization plan
Duration varies (about 30–90 minutes) based on anatomy and complexity.
Benefits and risks
Potential benefits
- Smaller incisions and less muscle disruption
- Earlier mobilization and shorter hospital stay in suitable patients
- Lower blood loss and reduced wound discomfort
Risks (no surgery is risk‑free)
- Infection, bleeding, nerve root injury, CSF leak, recurrent herniation
- Incomplete relief if the pain generator differs from imaging
- Need to convert to another approach for safety
We discuss your personalized risk–benefit profile, alternatives, and expected timelines before making a decision.
Recovery and return to activity
Recovery Timeline
- Day 0: Walking begins with supervision once fully awake
- Days 1–7: Gentle walking; avoid heavy lifting, bending, twisting; wound care as instructed
- Weeks 2–4: Gradual return to desk work; progressive core stabilization and posture training after wound healing
- Weeks 4–8: Graded increase in activity; manual workers follow a phased plan
Red Flags
Fever, new/increasing weakness, wound drainage, severe leg pain—contact the team promptly
Return‑to‑work guidance (typical ranges; individualized)
- Desk/remote roles: 1–2 weeks
- Light field work: 2–4 weeks
- Heavy/manual work: 4–8+ weeks with graded re‑entry
Costs and insurance
We provide a written estimate after evaluation. Many policies cover indicated in‑patient procedures with pre‑authorization. Day‑care discharge is feasible for some patients when safety criteria are met; otherwise, an overnight stay is recommended. Bring your policy details and MRI to streamline planning.
When MISS may not be preferred
- Overt spinal instability or deformity requiring stabilization
- Extensive canal compromise needing wider decompression
- Early in conservative care when non‑surgical therapy is still likely to work
Why choose Dr Sayuj Krishnan at Yashoda Hospitals – Malakpet
- Expertise in Full Endoscopic Spine Surgery and minimally invasive techniques
- Safety‑first protocols with neuronavigation and neuromonitoring where indicated
- Clear counseling, realistic expectations, and structured follow‑up
- Patients visit from Malakpet, Charminar, Koti, Himayat Nagar, Abids, Secunderabad, Hitech City, Banjara Hills, Gachibowli, and LB Nagar
Frequently Asked Questions
Is MISS safe for older adults?
With careful selection and medical optimization, many older adults do well with MISS. We assess anesthesia fitness, comorbidities, and support at home before recommending surgery.
How painful is recovery?
Discomfort varies, but smaller incisions often mean less early pain. We use multimodal pain control and early mobilization to help you recover comfortably.
Will I need physiotherapy?
Yes. After wound healing, a graded plan focuses on core stabilization, posture, and safe returns to daily tasks and work.
Can the disc re‑herniate?
Recurrence can happen after any decompression. We minimize risk with precise technique and clear activity guidance, but no approach can eliminate risk completely.
What if endoscopy isn't possible on the day?
Safety comes first. If visualization/access is limited, we may convert to a microscopic approach—this is discussed in advance during consent.
Is day‑care discharge realistic?
Many patients qualify. If pain control, mobilization, or monitoring needs suggest otherwise, we recommend overnight observation.
Related Services
Endoscopic Foraminotomy
Minimally invasive nerve decompression for foraminal stenosis
Endoscopic ULBD
Unilateral approach to bilateral decompression
Brain Tumor Surgery
Advanced neurosurgical techniques
Related Conditions
Spinal Stenosis Treatment
Comprehensive treatment for spinal canal narrowing
Slip Disc Treatment
Advanced treatment for herniated discs
Call to action
Book a consultation at Yashoda Hospitals – Malakpet. Bring prior imaging and policy details to confirm candidacy and a tailored plan.
Schedule ConsultationReferences
MISS is one of several safe, evidence‑based options for selected patients. After examining you and reviewing your MRI, we'll confirm if endoscopic or microscopic decompression—or continued conservative care—is the best next step. Book a consultation at Yashoda Hospitals – Malakpet to receive a personalized plan and timeline.
Disclaimer
This page is educational, not a substitute for medical advice. Decisions are made after clinical evaluation and imaging review. Outcomes are not guaranteed.