Minimally Invasive Spinal Surgery Using Instrumentation

Abstract

Background and Purpose: With the advance of better optics and operative equipment, image-guided systems, new biological agents, and instrumentation systems, spinal surgery can now be performed in a minimally invasive way. We report our concept and recent cases of less invasive spinal surgery using instrumentation. Method and Results: We used spinal instrumentation in 174 cases among recent 581 cases for cranio-cervical junction cervical, thoracic and lumbar lesions. The instrument were used for occipito-cervical and anlanto-axial fixation (21 cases), anterior and posterior reconstruction for cervical disorders (127 cases), and thoracic and lumbar fixation (26 cases). Satisfactory improvement as scored on the Neurosurgical Cervical Spine Scale (NCSS) and Japanese Orthopedic Association (JOA) scale, and complications in spinal instrumentation cases were examined compared with non-instrumentation cases. There are no differences in the surgical result and complication rate, but average hospitalization time is significantly shorter in cases with instrumentation (121 cases) than without instrumentation (115 cases) in cases of anterior reconstruction of the cervical spine (P < 0.01). Conclusions: Minimally invasive surgical procedure using spinal instrument with appropriate patient selection may raise the cost of the operation, but can be undertaken with acceptable mortality and morbidity rate and offer short hospital stay and quicker return to work by immediate stabilization.