1. MINIMALLY INVASIVE SPINE SURGERY TECHNIQUE OUTCOMES OCCUPATIONAL THERAPY

2. TYPES SPINAL FUSION- Immobilization of vertebral bodies/motion segments with instrumentation DISKECTOMY- Spinal decompression from vertebral disk herniation. Removal of disk material relieves pressure on spinal cord/root nerves.

3. Advantages Less disturbance of soft tissues, nerves, and muscles during procedure Less scarring Decreased length of stay post-operatively. Less bleeding Cosmesis (smaller incision) Reduced pain and narcotic usage Quicker return to normal activities

4. Disadvantages Requires use of fluoroscopy ( C or O arm) to achieve visualization Higher exposures to radiation from fluoroscopy Longer surgical times High learning curve for surgeons Not suitable for all patients/cases Exposes less bone surface area for fusions More difficult dural repair if damaged

5. Potential Complication Infection Bleeding Pneumonia/Lung problems Anesthesia complications Recurring symptoms Pseudarthrosis Hardware fracture Implant/graft migration Spinal cord/nerve damage Post-operative DVT Dural tear Transitional Syndrome Sexual dysfunction

6. Equipment/Instrumentation

7. Open vs. MIS

8. MIS Surgery Video Q

9. OT Following Surgery Instruction in the proper techniques for putting on/taking off your back/neck brace Reinforcement of BLT Precautions Transfer procedures: to EOB, Bed to Chair, Bed to Walker, and Walker to Toilet/Shower chair Instruction in compensatory techniques for ADL’s( sock aids, reachers, AE/AD devices) Instruction in toileting, showering, self-care Education for patient/family/care-givers

10. Assistive Devices

11. OT Back Surgery Video

12. Bed/Chair Positioning Precautions HOB elevated no more than 30 degrees Log roll in bed to turn, never twist Lie on back with pillow under legs Lie on side, both knees bent with pillow between knees. Do not put arms under head Pillow behind back to prevent rolling Avoid slouching in chairs, keep shoulders, hips, and ears aligned Choose a chair that has good support Avoid soft chairs, couches, and recliners Keep feet flat on floor, and knees level with hips Do not sit for too long, stand and stretch occasionally To stand up, slide to edge of chair and use knees and hips to straighten Use arms to help support and lift if possible

13. Questions References: http://www.google.com/search?q=back+surgery+assistive+devices&client=safari&rls=en&tbm=isch &prmd=ivns&ei=5Jc6VJn4Ds-LyASHuYDACw&start=20&sa=N http://www.google.com/search?q=back+surgery+assistive+devices&client=safari&rls=en&tbm=isch &prmd=ivns&ei=5Jc6VJn4Ds-LyASHuYDACw&start=20&sa=N http://orthoinfo.aaos.org/topic.cfm?topic=A00543 http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Minimally%20Inv asive%20Spine%20Surgery%20MIS.aspx http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Minimally%20Inv asive%20Spine%20Surgery%20MIS.aspx http://umm.edu/programs/spine/health/guides/complications-of-spine-surgery http://www.understandspinesurgery.com/Articles/Read/Minimally-Invasive-Surgery-(MIS)-for- Spinal-Problems http://www.understandspinesurgery.com/Articles/Read/Minimally-Invasive-Surgery-(MIS)-for- Spinal-Problems http://www.hopkinsortho.org/JHULumbSpineSurgeryGuide.pdf http://www.basicspine.com/blog/minimally-invasive-spinal-surgery-used/ http://www.practicalpainmanagement.com/treatments/interventional/minimally-invasive-spine- surgery-who-can-it-help http://www.practicalpainmanagement.com/treatments/interventional/minimally-invasive-spine- surgery-who-can-it-help http://www.zimmer.com/en-AU/hcp/spine/product/pathfinder-minimally-invasive-pedicle- screw.jspx http://www.zimmer.com/en-AU/hcp/spine/product/pathfinder-minimally-invasive-pedicle- screw.jspx https://www.youtube.com/watch?v=QYXJv01SvyA https://www.youtube.com/watch?v=2o00O0l1my4 http://www.ilcnsw.asn.au/items/357?topic_header=additional_info