Minimally Invasive Spine Surgery: Techniques, Technologies, and Indications

Abstract

Over the past few decades, interest in minimally invasive spine surgery (MISS) has increased tremendously due to its core principle of minimizing approach-related injury while providing outcomes similar to traditional open spine procedures. With technical and technological advancements, MISS has expanded its utility not only to simple spinal stenosis, but also to complex spinal pathologies such as metastasis, trauma, or adult spinal deformity. In this article, we review the techniques and technology in MISS and discuss the indications, benefits, and limitations of MISS.

Keywords: Endoscopic; Lateral lumbar interbody fusion; Minimally invasive spine surgery; Navigation; Transforaminal lumbar interbody fusion.

Fig. 1.

(A, B) Operative field of biportal endoscopic spine surgery. The surgeon is a right-handed person. (C) Intraoperative endoscopic view showing decompressed dura of the ipsilateral side.

Fig. 2.

Oblique lumbar interbody fusion in a 62-male patient. (A) Preoperative lateral radiograph showing L3–4 degenerative spondylolisthesis. (B) Intraoperative fluoroscopy-assisted cage insertion. (C, D) Postoperative anteroposterior and lateral radiographs.

Fig. 3.

Intraoperative two- and three-dimensional imaging system for navigation. (A) The O-arm system (Medtronic Sofamor Danek, Memphis, TN, USA). (B) Intraoperative navigation for pedicle screw fixation using StealthStation system (Medtronic Sofamor Danek).