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Minimally Invasive Procedures
At Capital Spine and Pain Institute, we offer state-of-the-art minimally invasive spine procedures designed to relieve pain and restore function with less muscle disruption, less scarring, and shorter recovery times compared to traditional open surgery.
Board Certified
Neurosurgeon
15+ Years
Experience
5000+
Procedures Performed
Get In Touch
Contact us today to schedule your consultation and take the first step toward relief.
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What Is Minimally Invasive Spine Surgery?
A modern surgical approach that treats your spine through small incisions—protecting surrounding muscles, shortening recovery, and getting you back to life faster.
Minimally invasive spine surgery (MISS) offers patients a way to treat painful spinal conditions without the extensive disruptions caused by traditional open spine surgery (OSS). In traditional OSS, large incisions are made to cut through multiple muscle layers to gain access to the spine. In MISS, your surgeon makes use of several small incisions, specialized tools, and thin tubes called retractors to access the spine. Your surgeon also uses real-time imaging to guide each step of the surgery.
With MISS, there is less damage to tissue around the target, less blood loss, and reduced pain after the surgery is completed. Additionally, patients are able to return to their normal daily routines much faster compared to traditional OSS. Unlike traditional OSS, MISS cannot be classified as a singular surgery, as it has many different applications when determining the appropriate spine procedure.
Imaging studies including MRI and X-rays are reviewed before surgery to plan every detail of the procedure. Nothing is improvised on the day of your operation.
20+ Procedures
Minimally Invasive
Insurance Accepted
Cash Pay Accepted
Patient-Focused Care
Types of Spine Injections We Offer
Lumbar Microdiscectomy
Lumbar Percutaneous Discectomy
Kyphoplasty
Conditions We Treat
Intervertebral Disc Herniation
When disc material presses against nearby nerves, causing pain, numbness, or weakness.
Spinal Injury
Trauma-related injuries that affect spinal stability and function.
Degenerative Spine Conditions
Age-related changes affecting discs, joints, and overall spine health.
Complex Spine Disorders
Advanced conditions requiring specialized surgical expertise and planning.
Scoliosis
A spinal curvature condition that can affect posture, mobility, and overall function.
Sciatica
Nerve pain radiating from the lower back into the leg due to compression or irritation.
Cervicogenic Headaches
Headaches that originate from issues in the cervical spine.
Cervical Spine Conditions
Conditions affecting the neck, often causing stiffness, pain, or nerve symptoms.
Thoracic Spine Conditions
Mid-back disorders that impact posture, movement, and comfort.
Lumbar Spine Conditions
Lower back conditions commonly responsible for chronic pain and limited mobility.
Sacral Spine Conditions
Conditions affecting the base of the spine and pelvis, often linked to nerve pain or instability.
When Is Minimally Invasive Spine Surgery the Right Choice?
We generally do not recommend surgical intervention. Most people come to our clinic after attempting conservative measures to manage their discomfort, such as physical therapy, medication, or receiving injections. Once we recognize the presence of a structural issue on imaging that is unlikely to improve with conservative management, we may discuss the option of surgical intervention.
The best candidates for surgery are patients with pain due to a clear structural issue, such as a compressed nerve, a collapsed disc, or instability in a particular segment of the spine, all of which can be corrected via a small surgical corridor. Minimally invasive surgery is advantageous due to the ability to address the problem with high levels of precision. Surgeons do not require a large field to locate a problem if they can visualize the anatomy of the issue via imaging.
Not all patients qualify for this type of surgical intervention. Factors such as the patient’s anatomy, the condition of their bone, and other variables, such as previous surgeries, may influence their candidacy. After reviewing patients’ spine imaging, their surgeons will advise them appropriately, as their surgical recommendations will be based on their anatomy, rather than a universal approach.
Why Choose Us
A Surgeon Trained Specifically for This Work Minimally invasive spine surgery requires a different skill set than open surgery. Your surgeon has fellowship training in complex spine procedures and has performed these techniques hundreds of times across a full range of spinal conditions.
Surgery Only When It's Genuinely the Right Answer If your imaging and symptoms suggest you'd do just as well with continued conservative care, that's exactly what you'll hear. We don't push patients toward the operating room. When surgery is recommended, it's because the structural problem makes it the right call.
Pre-Operative Planning That Actually Matters Every case is planned from your specific MRI and X-rays before you arrive at the facility. Approach angles, tool sizing, and anatomy are mapped in advance. There are no surprises.
Real Follow-Up, Not a Handoff Recovery from spine surgery requires ongoing support — imaging at the right intervals, physical therapy coordination, and access to your surgeon when questions come up. You'll have that throughout your recovery.
Honest Conversations in Plain Language You'll understand your diagnosis, your options, and exactly what surgery involves before you make any decision. That's the only way we know how to do this.
Key Benefits
Less Muscle Damage
Small incisions and tubular retractors move muscle aside rather than cutting through it. This is one of the most important differences from open surgery — and a major reason recovery is faster.
Reduced Blood Loss
The smaller surgical field typically means significantly less blood loss during the procedure, which reduces risk and speeds healing.
Lower Infection Risk
Smaller incisions mean less wound surface area exposed during and after surgery, which translates directly into a reduced risk of post-operative infection.
Less Post-Op Pain
Because the muscles and soft tissue are largely preserved, patients consistently report less pain coming out of minimally invasive procedures compared to open surgery.
Faster Return to Daily Life
Many patients with sedentary jobs are back at their desks within one to two weeks. The smaller the footprint of the surgery, the quicker the body bounces back.
Same-Day or Next-Day Discharge
Depending on the procedure, many patients go home the same day. You recover in your own home, not a hospital bed.
How the Procedure Works
01
Pre-Op Imaging Review
Before anything else, your MRI and X-rays are carefully reviewed to map the exact anatomy involved. The level of the problem, the position of nerves and blood vessels, and the size of any needed implants are all confirmed in advance.
02
Anesthesia
Depending on the type of procedure, you may receive local anesthesia (awake but fully numb) or general anesthesia (fully asleep). Your anesthesiologist will review the plan with you before surgery.
03
Small Incision
One or more incisions—typically a fraction of the size of an open surgical incision—are made through the skin. A series of progressively larger dilators are used to create a working channel through the muscle without cutting it.
04
Retractor Placement & Visualization
A tubular retractor holds the small opening in place. Your surgeon then works through this tube using a microscope or endoscope for clear, magnified visualization of the surgical site.
05
The Procedure
Depending on your diagnosis, this may involve removing a herniated disc fragment, trimming overgrown bone or ligament compressing a nerve, placing implants to stabilize a segment, or performing a fusion. The specific steps are determined by what your imaging shows.
06
Closure & Discharge
Retractors are removed, muscles return to their natural position, and the incision is closed. Most patients are discharged the same day or the following morning with clear instructions for recovery at home.
What to expect week by week
Recovery varies, but here's how most patients progress.
Same Day
Completed. Rest at home.
You'll need a driver — don't plan on doing anything for the rest of the day.
Days 1–3
Normal Soreness.
Swelling typically peaks around day two and begins to settle. Pain medication helps manage discomfort during this window.
Week 1–2
You should feel a difference.
Most patients with desk jobs are back to work by the end of the first or second week. Short walks are encouraged. Heavy lifting and bending are restricted.
Weeks 3–6
Activity gradually increases.
Physical therapy typically begins during this phase to rebuild strength and mobility. Most patients notice meaningful improvement in their original symptoms by this point.
Months 2–6
Continued healing and strengthening.
For fusion procedures, bone consolidation continues over this period. Follow-up imaging confirms progress.
Expert Spine Surgeon
Dr. Avery L. Buchholz is a board-certified neurosurgeon with fellowship training in complex spine surgery. With over 15 years of experience and 5,000+ procedures performed, he specializes in both minimally invasive and complex surgical techniques.
His expertise spans the full spectrum of spine care, from non-surgical interventions to advanced reconstructive procedures, always prioritizing patient safety and optimal outcomes.
Frequently Asked Questions
What makes minimally invasive spine surgery different from traditional open surgery?
Open surgery requires a long incision and significant muscle retraction to give the surgeon a clear view of the spine. Minimally invasive surgery achieves the same goals through one or more small incisions, using tubes, cameras, and microscopes to work in a much smaller space. The result is less muscle damage, less blood loss, and a faster recovery.
How do I know if I'm a good candidate?
The best candidates are people who have a clearly identified structural problem on imaging and have already tried conservative treatment without lasting relief. A consultation with your imager is the right starting point—your surgeon will tell you directly whether you qualify.
How long does surgery take?
It depends on the procedure. Simpler decompressions may take under an hour. More complex reconstructions or multi-level fusions take longer. Your surgeon will give you a time estimate specific to your case.
Will I have pain after surgery?
Some soreness is expected, particularly at the incision site in the first few days. Because the minimally invasive approach spares muscle tissue, most patients are surprised by how manageable their post-operative pain is compared to what they anticipated.
When can I go back to work?
Patients with desk jobs typically return within one to two weeks. Physically demanding jobs require a longer recovery — usually four to six weeks minimum. Ask your surgeon about your specific job requirements.
What are the risks?
All surgery carries risk. The most common concerns are bleeding, infection, nerve injury, and in fusion cases, the possibility that the bones don't heal together as expected. Your surgeon will walk through the specific risks relevant to your procedure before you consent to anything.
How long does full recovery take?
It varies based on the type of procedure, your age, and your overall health. Many patients feel meaningfully better within a few weeks. For fusion procedures, the bone continues to mature for three to six months — and sometimes longer — after surgery.
Is minimally invasive spine surgery covered by insurance?
In most cases, yes — provided you have a confirmed diagnosis and documentation showing that conservative treatment was tried first. Prior authorization requirements vary by insurance plan. Our team handles the paperwork so you don't have to.
Our Locations
Serving patients across VA and the DC area
Falls Church, VA
6400 Arlington Blvd, Suite 710
Open
Alexandria, VA
6244A Little River Turnpike
Open
Richmond, VA
Address coming soon
Opening Soon
Charlottesville, VA
Address coming soon
Opening Soon
Washington, DC
Address coming soon
Opening Soon
Get In Touch
Contact us today to schedule your consultation and take the first step toward relief.
Address
6244 Little River Turnpike, Suite 101
Alexandria, VA 22312
Phone
FAX
Office Hours
Monday - Friday: 9:00 AM - 6:00 PM
Saturday: 9:00 AM - 6:00 PM
Sunday: Closed
This form is intended for scheduling purposes only and is not a HIPAA-compliant form. Please avoid sharing any sensitive medical information.
By submitting, you consent to being contacted using the information provided.
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