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Minimally Invasive Spine Surgery: What to Expect Before, During & After

Minimally Invasive Spine Surgery

Minimally invasive spine surgery has transformed how we treat conditions such as herniated discs, spinal stenosis, and spondylolisthesis. Unlike traditional open procedures, these techniques use small incisions, specialized tools, and imaging guidance to access the spine with less disruption to surrounding muscles and tissues.

The result is significant: shorter hospital stays, less post-operative pain, and faster return to normal activity.

As a neurosurgeon in San Diego with fellowship training in spine surgery, I’ve performed hundreds of these procedures, including the MiTLIF (minimally invasive transforaminal lumbar interbody fusion). This technique is particularly effective for stabilizing the lower back while preserving spinal mobility.

This guide walks you through the entire process from preparation to recovery, so you know what to expect if minimally invasive spine surgery is recommended.

Quick Answer

Minimally invasive spine surgery in San Diego involves small incisions, tubular instruments, and real-time imaging to treat spinal conditions with minimal muscle disruption. Patients typically walk the same day, go home within 24 hours, and return to work or light activity within two to six weeks (typical in select cases). Common procedures include MiTLIF, microdiscectomy, and decompression for spinal stenosis.

Preparation: Steps Before Your Procedure

The weeks before surgery focus on optimizing your health and ensuring you understand each step. Preparation often includes:

  • Initial Consultation and Imaging: Expect a thorough exam, along with MRI or CT scans to pinpoint the affected level. For MiTLIF candidates, we’ll review how the approach targets the foramen (the nerve exit pathway) to relieve compression while minimizing tissue exposure.
  • Medical Clearance: Pre-op blood work and cardiac evaluation may be needed. You’ll also receive guidance about stopping blood thinners 7–10 days prior and quitting smoking, as this speeds healing.
  • Lifestyle Adjustments: Gentle exercise, a balanced diet, and arranging support at home for the first few days after surgery all make recovery smoother.

Most patients find this phase reassuring, since it builds confidence in the plan and sets realistic expectations. Clear communication with your surgical team is key.

Learn more about Minimally Invasive Spinal Surgery options available in Dr. Ghosh’s San Diego practice.

The Procedure: What Happens in the Operating Room

On the day of surgery, the goal is precision with minimal invasion.

  • Anesthesia and Positioning: General anesthesia ensures complete comfort. You’ll be positioned face down on a specialized table that keeps the spine in a neutral alignment.
  • Incision and Access: A one- to two-inch incision is made using fluoroscopic (X-ray) guidance. Tubular retractors gently separate, rather than cut, the muscles to create a narrow working channel.
  • Core Steps (MiTLIF Example): In a MiTLIF, the damaged disc is removed through the foramen, a bone graft or cage is placed to restore disc height, and screws secure the area for fusion. The process typically takes one to three hours, depending on the number of spinal levels treated.
  • Closure and Recovery: The incision is closed with absorbable sutures or surgical glue. You’ll recover in a monitored area before moving to a short-stay unit.

Throughout surgery, intraoperative neuromonitoring tracks nerve function to ensure safety. Many patients are surprised by how streamlined and routine the experience feels.

Recovery: Timeline and Milestones After Surgery

Recovery from minimally invasive spine surgery in San Diego is one of its greatest benefits. Many patients are up and walking within hours and return home the same day.

Please note: The timeline outlined below is a general guideline only; individual recovery can vary significantly depending on your specific procedure, overall health, and how closely you follow post-operative instructions.

PhaseTimelineWhat to Expect
Immediate Post-OpDay 0–1Mild soreness managed with oral medication. Short walks encouraged. You’ll go home once mobility and vitals are stable.
Early RecoveryWeek 1–2Increase walking gradually. Avoid bending or twisting. A follow-up visit ensures incision healing.
Active HealingWeeks 3–6Begin physical therapy for posture and core strength. Many return to light work or driving. Bone fusion begins forming by month two for MiTLIF patients.
Full ReturnMonths 2–6Resume exercise, golf, or hiking. By six months, most report significant pain relief and solid fusion on imaging.

Stay hydrated, follow post-op instructions carefully, and contact your surgeon immediately if you experience fever, drainage, or new neurological symptoms.

Complication rates tend to be lower in minimally invasive approaches in select patients; in one large matched fusion study, the revision surgery rate at 12 months was 4.1% in MIS vs 5.6% in open surgery.

Potential Challenges and Long-Term Outlook

While recovery is generally smoother than open surgery, some patients may experience temporary stiffness, fatigue, or nerve sensitivity. These issues usually resolve with time and guided rehabilitation.

Many patients experience significant pain relief and improved function after procedures such as MiTLIF; for example, a systematic review in geriatric patients found meaningful improvements in pain and disability scores out to 12 months, though outcomes may vary.

Factors such as age, bone health, and adherence to post-op therapy influence outcomes. Regular follow-ups allow your care team to monitor progress and fine-tune your recovery plan.

Why Choose a Neurosurgeon for Minimally Invasive Surgery

Not all spine surgeons have the same training. Both orthopedic and neurosurgeons perform spinal procedures, but neurosurgeons complete residency focused on the nervous system, the brain, spinal cord, and peripheral nerves.
This expertise translates into precise nerve handling, microsurgical skill, and advanced knowledge of spinal anatomy.

Dr. Sanjay Ghosh, a board-certified neurosurgeon in San Diego, is fellowship-trained in spine and skull base surgery. He has served as Director of Neurosurgery at the SENTA Clinic for over a decade and is consistently recognized as a Castle Connolly Top Doctor and San Diego Magazine Top Doctor.

Final Thoughts

Minimally invasive spine surgery offers the possibility of faster healing, smaller incisions, and long-term relief from back or leg pain. But success depends on understanding each stage and working closely with your surgical team.

If you’ve been recommended for MiTLIF or another minimally invasive spine procedure, being informed is your best preparation.

Dr. Sanjay Ghosh is a board-certified neurosurgeon at SENTA Clinic in San Diego, fellowship-trained in spine and cranial-base surgery. This content is educational and not a substitute for personalized medical advice.

Key Takeaways

  • Minimally invasive spine surgery uses small incisions and advanced imaging for faster recovery.
  • The MiTLIF procedure stabilizes the lower back while preserving motion and reducing pain.
  • Many patients walk the same day and resume normal activity within six weeks.
  • Long-term outcomes show high success rates and satisfaction.
  • Dr. Sanjay Ghosh provides advanced, patient-centered care in San Diego at the SENTA Clinic.

If you’re considering minimally invasive spine surgery in San Diego and want expert guidance tailored to your condition, schedule a consultation with Dr. Sanjay Ghosh today. Call or text (619) 810-1010 or visit our contact us page to request an appointment.

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Patients who regained strength and independence through precise, compassionate care.

Thank you to a man who comes to this church, who’s one of the great surgeons. He did something that’s pretty much impossible. His name is Sanjay Ghosh.
 Everybody wants to know who did Donna’s surgery — I’m just going to tell you straight out: it’s him. You do what you want to do with that, but that’s true. And he’s amazing, and we’re so grateful. He was a gift of God to us at this particular time.

Dr. David Jeremiah
Shadow Mountain Community Church 
Dr. David Jeremiah
Shadow Mountain Community Church 

For the most of my life, I have trained and presented wildlife in public conservation education programs and the media. My work is often very physically demanding and I have used the Senta Clinic and Dr. Sanjay Ghosh to treat my spinal issues and keep me able to continue my work and manage my pain.

Joan Embery
Wildlife Expert, and TV Personality
Dr. David Jeremiah
Shadow Mountain Community Church 
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Elisha G.
Practice Relations Liaison

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Meet Lauren
Lauren G.
Assistant Office Manager

Lauren was born and raised in San Diego, California. She attended San Diego State University, graduating with a Bachelor of Arts degree in Communication in 2013. She began her professional journey in the hospitality field where she discovered her passion for helping others and building relationships. This eventually inspired her to pursue a career in healthcare, joining Sharp Healthcare in 2016 where she found great fulfillment in learning and growing within the medical field. Lauren began working with Senta Neurosurgery in 2017 supporting Dr. Sanjay Ghosh.

When not at work, Lauren enjoys spending time with her family, being an Auntie, traveling, and being outdoors.

Dr. Ghosh, I just wanted to take a moment & thank you again for all you have done for my husband, Benton (Rick) Coulter. June 26th he was brought by ambulance to Grossmont Hospital. That was the beginning of the scariest days of our lives. When we were told he needed brain surgery we were stunned, confused & not sure what to do. We asked for a second opinion by you. Within 30 minutes you were at Rick’s bedside. You were friendly, caring & confident. After examining him you told us he would need two surgeries instead of one. You even called me at home to answer our many questions. Thank you for treating us with such respect. You were available & patient as we tried to make a decision. Once we decided you were the right Dr. we had continuous confirmations that we had chosen the right one. We will be forever grateful to you! You saved my husband’s life and his sight. God used you in a mighty way & He answered our prayers. Thank you for all the work it took to be a Brain Surgeon & to help others like us. You are not only skilled but you are also caring. We appreciate you so much.
Sincerely, Karen Coulter
So far I have been taken great care of by Dr. Ghosh and his staff. Dr. G has spent quality time with me reviewing my symptoms and MRI’s etc that are a result of a day at a water park turn into one of the worst injuries I have ever had. What I appreciated the most was our efforts as a team to exhaust all options of pain management and PT before coming to the decision that no relief is in sight without surgery. I had already been referred to Dr. G’s office by other friends and patients so I’m very comfortable moving forward with Dr. Ghosh and his team.
Former Patient
I was referred to Dr. Ghosh by my corporate physician. She had heard good things about Dr. Ghosh. I went to several other neurosurgeons. They were all excellent but I just liked Dr. Ghosh’s confidence and frank manner. My surgery was quick and the result was excellent. My recovery time was minimal. The incision, with a little more time will be minimal and not noticeable. The pain I have felt for a long time is gone. I’ve noticed that others feel that Dr. Ghosh and Amanda did not spend enough quality time with them. My time with them was brief. I don’t need alot of hugs and hand holding. I just needed them to provide me with the information I needed to make decisions, which they did to my satisfaction. They are seeing alot of patients. I don’t think it would be fair to others if Dr. Ghosh and Amanda had to spend several hours caring for my psychological needs when all they really needed to do is fix my neck. Amanda is truly capable. I had an issue late on a holiday night. I called. They transferred me to her even though she was at a social event. I explained to her my concerns. She told me what to expect and under what circumstances to come back to the office.For those who felt abandoned and that they didn’t get enough time, you might find other surgeons even more unavailable. Dr. Ghosh stated he was starting to take less patients to try and spend a little more time with each patient. I hope he doesn’t. It won’t be fair to the people who won’t benefit from his talents. A special thank you to Dr. Ghosh and his team.
Former Patient
Meet Edith
Edith Smith
Director of Operations

Edith was born in Budapest, Hungary and immigrated to Los Angeles, CA as a small child.  She later received a Bachelor of Arts degree in Economics from the University of California, San Diego in 1996. From 1997 to 2002, she worked as a Program Manager at Qualcomm, during which time she also obtained a Certificate in Project Management from the University of San Diego. Edith took some time off to start her family but remained active in her volunteer efforts supporting Rady Children’s Hospital Auxiliary, where she co-chaired nine large fundraising events and served on the Board of Directors for 5 years. During her time at Rady Children’s, Edith became passionate about healthcare and neurosurgery in particular when her daughter became a neurosurgical patient at Radys. Edith joined Senta Neurosurgery’s team supporting Dr. Sanjay Ghosh’s practice in 2019. Given her personal experiences, Edith knows that getting a referral to neurosurgery is a stressful, life altering event, so she truly appreciates being part of the patient care process for Dr. Ghosh’s patients.

When not at work, Edith enjoys spending time with her friends and family, traveling, cooking, and entertaining.

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Melissa Padilla
Surgery Coordinator

Melissa has an Associate of Science Degree in Medical Office Administration. She has worked in healthcare for over 25 years. She started out working in a radiology department processing film and scheduling exams. Melissa joined Dr. Ghosh’s team in 2003 and uses her skills and experience to schedule Dr. Ghosh’s patients for surgery.  She is a fierce advocate for our patients throughout the entire prior authorization and scheduling process, and her goal is to make the scheduling of our patients’ surgeries organized and stress free so that our patients can focus on healing.

Meet Deborah
Deborah Updike
M.M.S, M.S., PA-C

Deborah is a California native. She attended American University in Washington, DC graduating with a Bachelor of Science in Marine Science and Environmental Studies. She was a college athlete, playing NCAA D1 volleyball all four years. She then attended California State University, Long Beach where she received a Masters of Marine Science in Shark Reproductive Physiology. During her first masters degree, she began transitioning into medicine and went on to receive her Master of Medical Science degree in Physician Assistant studies at Midwestern University in Downers Grove, IL. Deborah served as class Vice President. She graduated in 2017 and has been working at Senta Neurosurgery ever since. Deborah is a member of the American Academy of Physician Assistants.

Meet Edith
Edith Smith
Director of Operations

Edith was born in Budapest, Hungary and immigrated to Los Angeles, CA as a small child.  She later received a Bachelor of Arts degree in Economics from the University of California, San Diego in 1996. From 1997 to 2002, she worked as a Program Manager at Qualcomm, during which time she also obtained a Certificate in Project Management from the University of San Diego. Edith took some time off to start her family but remained active in her volunteer efforts supporting Rady Children’s Hospital Auxiliary, where she co-chaired nine large fundraising events and served on the Board of Directors for 5 years. During her time at Rady Children’s, Edith became passionate about healthcare and neurosurgery in particular when her daughter became a neurosurgical patient at Radys. Edith joined Senta Neurosurgery’s team supporting Dr. Sanjay Ghosh’s practice in 2019. Given her personal experiences, Edith knows that getting a referral to neurosurgery is a stressful, life altering event, so she truly appreciates being part of the patient care process for Dr. Ghosh’s patients.

When not at work, Edith enjoys spending time with her friends and family, traveling, cooking, and entertaining.

Meet Felix
Felix Regala
MPAP, PA-C

Felix was born and raised in Abilene, Texas where he graduated from Abilene High School in 2001. He was honored with the Chuck and Doris Moser Scholarship for his accomplishments as a varsity athlete in baseball and his excellence in academics and community service. He then attended Baylor University where he graduated in 2004 with a Bachelor of Science degree in biology. Felix then spent a couple of years working in the laboratory at the Salk Institute for Biological Studies and Johnson & Johnson. He then went on to the Keck School of Medicine at University of Southern California to obtain his Master of Physician Assistant Practice degree. Felix graduated from physician assistant school in 2010. While pursuing his PA degree at USC, Felix served as class president and spent time training in neurosurgery and orthopedic spine.  Felix has been a PA with Dr. Ghosh since May 2011.

Felix enjoys being active, including playing basketball, surfing, snowboarding, golfing, and exercising. Felix is also a member of the American Academy of Physician Assistants and the California Academy of Physician Assistants.

Meet Amanda
Amanda W. Gumbert
M.M.S, PA-C

Amanda received her Bachelor of Science degree in Kinesiology at San Diego State University in 2002. She worked as an Exercise Physiologist at the Cardiac Treatment Center at Scripps Memorial Hospital La Jolla before going to PA School. Amanda graduated from Midwestern University in Glendale, Arizona with a Master of Medical Science degree in Physician Assistant studies in 2005. She began working for Dr. Ghosh in January 2006 working as the senior Physician Assistant and manager of the PAs.   Amanda has spoken at the national level at the AAPA conference on various neurosurgical topics. She is highly committed to the future Physician Assistants and frequently has students shadow her and acts as a PA student preceptor. She is a member of the American Academy of Physician Assistants, Association of Neurosurgical Physician Assistants, and The San Diego Society of Physician Assistants.  Amanda is honored to be a finalist for San Diego Magazine’s Woman of the Year— 2025 Healthcare Pioneer.

When not working, Amanda enjoys hiking, mountain biking, stand up paddle boarding, snowboarding, playing with her dogs and spending time with her family.

San Diego Magazine’s Celebrating Women
2025 Healthcare Pioneer Finalist