What Is The Minuteman Procedure?
The Minuteman is a fusion device and an interspinous spacer used for fixation and stabilization of the spine in patients with back pain, buttocks, legs, or foot pain due to degenerative disc disease, trauma, spondylolisthesis, or tumor. The Minuteman is an alternative to traditional fusion surgery and a less invasive procedure, that is better for patients who can not handle traditional surgery or general anesthesia due to co-morbid conditions.
Dr. Harold Hess, MD, a Board Certified Neurosurgeon, developed this device in May 2011. In January 2015, it was approved by the FDA in the United States. The Minuteman Procedure, a minimally invasive procedure, has provided relief from chronic back and leg pain to more than 2000 people.
request appointmentWhy Is The Minuteman Procedure Performed?
The Minuteman Procedure is a primary treatment for lower back pain. It is designed to treat degenerative disc disease. Degenerative disc disease (DDD) occurs with aging and wear and tear in the human body. It is also indicated in patients with mild to moderate spondylolisthesis and spinal stenosis (spinal canal narrowing). It is preferred in patients with comorbidities like diabetes, heart diseases, adjacent segment disease (ASD), adjacent segment degeneration, and those who can not handle preoperative (like general anesthesia), intraoperative and postoperative complications.
What Is Degenerative Disc Disease?
26 moving vertebrae and 23 discs make your spinal column. These discs act as cushions in your spinal column in all vertebrates. These discs are like shock absorbers that help the body bend, twist, and flex. Wear and tear normally occurs with aging, which leads to disc degeneration, usually around 40 years of age. It progresses with advancing age. The cushioning effect of spinal discs vanishes, and they start rubbing bony surfaces, causing chronic back pain. Other back problems like scoliosis, herniated discs, spondylolisthesis, or spinal stenosis may emerge.
What Are The Symptoms Of Degenerative Disc Disease (DDD)?
Few people may not experience symptoms of degenerative disc disease, but people with significantly worn down discs may feel back pain. The cervical spine (in the neck) and lumbar spine (lower back) can be affected by degenerative disc disease.
Following are the symptoms of degenerative disc disease when the lumbar spine is affected:
- The patient feels pain over bending, lifting heavy objects, and twisting the body.
- Pain worsens on sitting or standing for a longer period of time and reduces by sitting or stretching the body in an ergonomically correct posture.
- Feeling of instability and muscle spasms in the lower back.
- Feeling of needles and pins (tingling) and numbness in the lower back that radiates towards the legs.
How Is The Minuteman Procedure Performed?
Patients with lower back pain are treated with non-surgical procedures first, like injections, medications, and physiotherapy. Sometimes, patients do not respond to non-surgical treatment, so surgical treatment is opted for such patients. The Minuteman is basically used for spinal fusion and corrective surgery for degenerative disc disease. It is an alternative to traditional surgeries that use roads, screws, and plates.
The Minuteman device has bilateral locking plates, a fixed plate, a core threaded post, and a locking hex nut. It is always packaged and sterilized. It has different sizes to perfectly fit the anatomy of the patient’s spine.
Before beginning the procedure, the patient is brought into the operating room and prepped by an attendant. A gauze soaked with an antiseptic solution is applied, and a local anesthetic agent is administered to numb the area. X-rays are used to mark the exact area for the Minuteman device.
The patient lies prone on the operation table, and the surgeon creates a 1-inch long incision. It is dilated with multiple tubes to open up the space and get access to muscles around the spine. A relatively small tube guides the Minuteman devices, and a bone graft is implanted.
After completion of the procedure, all tubes and tools are removed, the incision is closed, and the bandage is applied. This procedure takes up to one hour only.
Advantages Of The Minuteman Procedure
Traditional fusion surgery is difficult to handle in patients with comorbidities like diabetes and health diseases. Preoperative, intraoperative, and postoperative complications are also difficult to manage in such patients. Recovery from transitional surgery takes several months, along with physiotherapy. This rigorous surgery can lead to spinal stenosis or adjacent segment disease (ASD).
In contrast, the Minuteman is a minimally invasive, FDA-approved device for fixation and stabilization of the lumbar spine. The incision length is only 1inch, and blood loss is around 20 ml. The patient can be shifted to home the same day and resume routine activities after 24 hours. The skin, muscles, and ligaments remain less affected than in traditional surgery.
Moreover, the Minuteman Procedure allows micro movement that reduces the risk of spinal stenosis or adjacent segment disease (ASD).
Another function of the Minuteman device is to prop open the spinal canal. It is fixed between the two spinous processes at the narrowest level that helps patients walk upright with greater comfort and stability.
Additionally, the Minuteman has hydroxyapatite (a naturally occurring calcium phosphate mineral) deposited in the center post screw that promotes bony fusion and stabilizes the unstable bony parts.
A study of patients with implanted Minuteman devices showed long-term benefits and relief from pain and discomfort. VAS score for leg pain was reduced by 80%, and the back pain was reduced by 50%. Oswestry Disability Index improved by 50% after 12 months of using the Minuteman device.
Disadvantages Of The Minuteman Procedure
Despite advances, the Minuteman Procedure may not provide adequate pain relief. Infection may also occur, and antibiotics are given to prevent infection. In case of failure, a patient may need open surgery. There are also chances of infection around the site of operation. These risks are significantly less in comparison with traditional surgery.