Philosophy and biology of minimally invasive spine surgery

Abstract

The last decades have shown an ongoing progress in minimally invasive spine surgery (MISS). The development and introduction of new surgical instruments, smaller tissue retractors, advancements in microscopy, improvement in medical imaging capability, the sensitivity of C-arm, along with the introduction of intraoperative CT scanning and navigation, have allowed for less soft tissue morbidity and shorter lengths of stay. Multiple studies have demonstrated that MISS is associated with lowering the soft tissue injury, decreasing postoperative pain, and shortening lengths of stay and recovery time. The key to successfully performing MISS procedures is a thorough understanding of various anatomical relationships between soft tissue planes, approach corridors, bony anatomy, and neurological structures. Minimally invasive procedures are technically demanding and require advanced training and mentorship. This chapter focuses on the philosophy and biology of MISS.