In the past, fixing damage caused by degenerative disc disease, disc herniation and degeneration, tumors, spinal deformities, and fractures required invasive spine surgery. However, modern technology now allows surgeons to correct these problems with minimally invasive spine surgery (M.I.S.S.), offering patients faster recovery times and fewer risks during surgery.

Dr. Alexander Taghva, M.D., F.A.A.N.S., is a highly regarded board-certified neurosurgeon with a strong focus on patient care. He performs minimally invasive spinal surgery for patients from Orange County and Southern California on an outpatient basis at his state-of-the-art medical facility in Mission Viejo.

What is M.I.S.S.?

Minimally invasive spine surgery is a type of surgical procedure that we perform to correct several spinal disorders. This may include degenerative disc disease as well as bone spurs. M.I.S.S. procedures minimize surgical trauma and scarring, therefore often requiring just one small incision to repair a damaged disc or relieve pressure on the spinal nerves.

Patients in Mission Viejo and Orange County often choose M.I.S.S. over traditional spinal surgery because it is a much quicker procedure with less downtime and that we perform on an outpatient basis. Minimally invasive spinal surgery in Mission Viejo also opens up the benefits of back surgery to patients who are unable to undergo a more invasive procedure for safety reasons.

Your Spine Surgery Consultation at our Orange County location

All patients will need to consult with Dr. Taghva before scheduling M.I.S.S. This consultation for minimally invasive spine surgery in Mission Viejo, Orange County, and Laguna Beach is important for determining candidacy and creating a surgical plan. During this appointment, we will discuss your medical history and disclose current medications and treatments.

Dr. Taghva will take X-rays, go over information from your medical history, ask questions, and then discuss your treatment options, which may include spinal surgery. The surgeon will go over what to expect during surgery and give pre- and post-operative instructions. He will also discuss the type of anesthesia and give you an idea of what to expect in the months following the procedure. For this reason, it’s important that you come prepared with a list of questions to ask the spine surgeon.

What Are the Benefits of M.I.S.S.?

There are many benefits to choosing minimally invasive spinal surgery over traditional surgery in Mission Viejo and Orange County. Some advantages include:

• Less pain and therefore reduced need for narcotics
• Quicker procedure (Dr. Taghva performs M.I.S.S. as an outpatient procedure)
• Less blood loss reducing the risk of needing a blood transfusion
• Much smaller incisions, resulting in less scarring than traditional open procedures
• Often more cost-effective than traditional spinal surgery
• Reduced risk of damage to the muscles and surrounding soft tissues
• Improved quality of life after surgery

What Does Minimally Invasive Spine Surgery Treat?

Minimally invasive techniques are often able to successfully treat spinal surgery patients who are suffering from different conditions. For instance, These may include spinal stenosis, disc degeneration, bone spurs, scoliosis, herniated discs in the lumbar spine and cervical regions, and spine deformities.

Dr. Taghva will provide you with a custom treatment plan to address your specific health concerns. He prefers to use minimally invasive surgical techniques whenever possible. However, not everyone is a good candidate for minimally invasive spine surgery in Orange County.

For the most part, patients with back pain related to a spinal defect may require open surgery. Open procedures involve making a large incision and moving the muscle back to directly access the spine. For instance, Individuals with narrowing of the open spaces in the spinal canal may not be able to be treated with minimally-invasive techniques and may require more extensive surgery.

Preparing for Minimally Invasive Spine Surgery

In preparation for M.I.S.S., Dr. Taghva recommends that his patients quit smoking and exercise before surgery to encourage a faster recovery. You should pause any non-essential medications or herbal supplements that could react with the anesthetic a few weeks ahead of time. This will be discussed during the consultation with Dr. Taghva.

What Are the Different Minimally Invasive Spine-Surgery Methods?

There are many methods that Dr. Taghva uses to perform M.I.S.S. in Mission Viejo and Orange County including:

Tubular retractor method

In short, this technique involves dilating the soft tissues vs. cutting through the muscle. It uses tubes to pull back the muscle and allows the surgeon to access the spine through a small incision rather than making a larger incision and exposing the open area, as is required with traditional spine surgery.

Dr. Taghva uses an endoscope, which is a tiny camera attached to a flexible tube, to assist in procedures with minimal access. Then, after the modifications are made, the surgeon removes the tubular retractor and the dilated tissues are returned to normal.

Percutaneous method

Sometimes, instruments like screws and rods must be placed to stabilize the spinal cord or keep the spine immobilized during spinal fusion. Percutaneous placement of these instruments is done through small skin incisions and without the need to cut through the underlying muscle tissue.

X-ray imaging is used alongside guidewires which are inserted into the vertebrae along the area where the screws will be placed. The screws contain extenders that the surgeon will remove after assisting in guiding the rods to tighten the screws.

Direct lateral access

When the lumbar spine is involved, the spinal column is often accessed through the side of the body. As a matter of fact, with this method, the patient will be lying on their side as the surgeon places a tubular retractor to access discs and bones in the spine.

Thoracoscopic access

Sometimes, accessing the front of the thoracic spine is necessary. Traditional surgery opens the chest through a large incision and sometimes requires one or more ribs to be removed. With the thoracoscopic approach, multiple small incisions are made so that the endoscope can be inserted to facilitate the procedure.

What Are the Treatment Options for Minimally Invasive Spine Surgery (M.I.S.S.)?

Minimally invasive spine surgery can treat a range of spine conditions using the following surgical techniques:

Discectomy: When spinal discs become weak, the tissue inside can herniate outside of the disc. For this reason, this herniated material can put pressure on the nerves, which can be very painful. When this occurs, the physician will often indicate surgical treatment to trim the herniated disc and relieve pressure on the spinal nerves. Using tubular dilators and an endoscope, discectomy can be performed using M.I.S.S.

Spinal decompression: Spinal stenosis is the medical term describing the narrowing of the vertebral canal, consequently, causing pressure on the nerves. For this reason, pain and numbness are common symptoms of spinal stenosis. When spinal surgery is recommended, the bone and soft tissues are often removed with tubular dilators and endoscope. Laminectomy and foraminotomy are common procedures we use to correct spinal stenosis.

Transforaminal lumbar interbody fusion: Also known as TLIF, we often use this technique when there is low back pain due to degenerative disc disease and disc herniation. The surgeon performs it through the back with the patient lying on their stomach. Dr. Taghva will typically make two small incisions and then he will insert pedicle screws and rods between the vertebrae. The surgeon then removes the intervertebral disc and then places a bone graft to stabilize the vertebral levels.

What to Expect After Minimally-Invasive Spine Surgery?

Minimally invasive spine surgery takes significantly less time to perform and recover from than traditional spinal surgery. Dr. Taghva will discuss how long your recovery is likely to be during your consultation, however since Dr. Taghva performs these surgeries on an outpatient basis in Mission Viejo, for this reason, no hospital stay is necessary. In fact, recovery time from M.I.S.S. is about half that of traditional open spine surgeries. For the most part, patients are often able to go back to work within two weeks and sometimes less.

Since endoscopic spine surgery does not disrupt the surrounding tissues and muscles of the spine. Patients can expect mild discomfort compared to that of an open surgery. For this reason, Dr. Taghva will prescribe medication in order to manage any pain and alleviate inflammation. For the most part, endoscopic spine surgery requires only a very small incision. Because of this, scarring is minimal, often only millimeters long. 

This is typical of what to expect following M.I.S.S., however, each specific situation may vary.

What Are the Possible Side Effects of Minimally-Invasive Spine-Surgeries?

Like every surgery, minimally-invasive spine surgery has its risks. For this reason, choosing a board-certified neurosurgeon keeps these possible side effects to a minimum. Some possible complications may include for example:

• Blood loss
• Infection
• Damage to the spinal nerves
• Blood clotting
• Anesthesia complications
• Spinal fluid leaking

Frequently Asked Questions About Spine-Surgery

Why Choose Dr. Alexander Taghva

Dr. Alexander Taghva is a leading board-certified neurosurgeon, specializing in brain surgery, endoscopic spine surgery, as well as spine disorders. Also, he is the only spine surgeon in Orange County and southern California who offers endoscopic laminotomy surgery. Dr. Taghva:

• Graduated from John Hopkins University School of Medicine and completed his residency at the University of California
• Completed a prestigious fellowship at The Ohio State University in Neuromodulation and Functional Neurosurgery
• Specializes in minimally invasive and endoscopic surgery, spinal stenosis, artificial disc replacement, spinal disorders, spinal surgery revision, and other spinal conditions.
• Specializes in brain surgery to treat trigeminal neuralgia, brain tumors, pituitary tumors, and Parkinson’s disease.
• A highly-respected neurosurgeon with many years of experience, including treating chronic pain via stimulation of the spinal cord and brain
• Actively involved in medical research and the lead investigator for clinical trials on spinal cord stimulation

Individuals in Orange County who wish to schedule a consultation for minimally-invasive spine surgery in Mission Viejo with Dr. Alexander Taghva should contact his office at 949-388-7190.