Dr Colum Nolan
Senior Consultant Spine & Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
Advances in surgical techniques have given patients more options when it comes to spine surgery. Minimally invasive approaches use smaller incisions, reduce trauma and disruption to surrounding tissue and often lead to faster recovery. In contrast, traditional open surgery still plays an important role in cases where broader access to the spine is required. Here’s how the two methods compare.
What Is Traditional Spine Surgery?
Traditional spine surgery, also known as open spine surgery, involves making a larger incision in the back or neck to move muscles and tissues aside, giving the surgeon direct visibility and access to the spine. This method allows for a clear, hands-on view, making it suitable for complex or extensive conditions.
It is typically recommended for patients with:
Severe Spinal Curvature (e.g. Scoliosis or Kyphosis)
When the spine curves excessively in the wrong direction, open spine surgery may be required to straighten and stabilise the spine effectively.
Unstable Spine After Injury
If a serious accident or severe fracture causes spinal instability, open surgery allows the surgeon to reinforce and realign the spine for safe recovery.
Multiple Worn-Out or Damaged Discs
For patients with severe degeneration at more than one spinal level, open spine surgery can provide better access to repair or replace the damaged discs and stabilise the spine.
Large Spinal Tumours or Infection
When a tumour or infection affects a large portion of the patient’s spine, the doctor will recommend open spine surgery to give a clearer view in removing the infection or tumour completely and safely.
Complex Conditions Not Suitable for Keyhole Surgery
In cases where minimally invasive (keyhole) surgery is not enough—such as very complex anatomy or extensive damage to the spine—open surgery would still be the safer and more effective option.
What Is Minimally Invasive Spine Surgery?
Minimally invasive spine surgery (MISS) is a modern surgical technique that treats spinal problems through small incisions, causing minimal disruption to the surrounding muscles and tissues. Surgeons use specialised instruments and advanced imaging to precisely guide the procedure without fully opening the back or neck.
MISS typically results in less post-operative pain, smaller scars and faster recovery times compared to traditional open surgery. However, it is only recommended for patients with generally less severe conditions, such as:
Herniated Disc
When the patient’s disc slips out of place or presses on nearby nerves, minimally invasive techniques can treat it without needing a large incision.
Spinal Stenosis (Narrowing of the Spine)
If a patient’s pinched nerves are caused by narrowed spaces in the spine, a doctor may recommend MISS. This procedure widens the affected area through a small incision, relieving pressure on the nerves.
Mild to Moderate Spinal Instability
For patients with minor vertebral slippage or early-stage degenerative changes, a surgeon may recommend minimally invasive spinal fusion. This procedure uses precise tools and a small incision to stabilise the spine.
Spine Fractures Without Major Displacement
If the patient has a spinal fracture that remains properly aligned, MISS may be sufficient to stabilise the affected area with less trauma to nearby muscles and tissue.
Which is Better For You?
The most suitable approach for you will depend on the condition being treated, its severity and your overall health.
Minimally invasive surgery is often preferred for patients who qualify, as it usually means smaller scars, less pain and a quicker return to daily activities. But in more complex cases, traditional open surgery gives the surgeon the visibility and access needed to achieve the safest and most stable outcome.
Your surgeon will evaluate factors such as the extent of spinal damage, the number of vertebrae involved, and any other medical conditions before recommending a treatment plan for you. Contact us today for personalised medical advice.
Our Spine Specialist in Singapore
Dr Colum Nolan
Senior Consultant Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
Dr Colum Nolan is a Senior Consultant Neurosurgeon and the Medical Director of Oxford Spine & Neurosurgery Centre. He undertook specialist neurosurgery training in Ireland and Australia, and later on completed a complex spine surgery fellowship at Addenbrooke’s Hospital in Cambridge, UK.
Dr Column held key leadership roles including Director of the Spine and Spinal Disorders Programme at the National Neuroscience Institute (NNI), as well as the Head of Neurosurgery Service at Sengkang General Hospital.
With his depth of experience, Dr Colum is committed to guiding each patient towards the safest and most effective treatment for their needs.
