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History and Evolution of Minimally Invasive Spine Surgery

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Minimally Invasive Spine Surgery

Abstract

Minimally invasive spine surgery (MISS) is a combination of specialized techniques, instruments, and technology for performing operations with less disruption of the adjacent tissues that surround the spine than traditional, open approaches. Three surgical objectives have driven the evolution of MISS: minimize tissue disruption, achieve bilateral decompression via a unilateral approach, and achieve indirect neural decompression. MISS began with the treatment of herniated lumbar intervertebral discs and has evolved tremendously since to be applicable to the treatment of a variety of spinal pathologies involving the entirety of the spinal column, including foraminotomies, fusion procedures, tumor resections, and fixation of traumatic fractures. The key elements of MISS include a small access approach to limit exposure-related tissue damage, magnification and illumination with the use of a microscope or endoscope, supplemental localization such as computer-assisted navigation, and surgical instruments that facilitate minimal access to the relevant spinal anatomy, all contributing to the goal of leaving the smallest possible operative footprint while achieving good clinical outcomes. The rapid advancement in technology has allowed the field to evolve significantly, such that traditional procedures that previously required larger exposures with increased morbidity are being effectively and efficiently performed in a minimally invasive fashion. In this chapter, the authors present a review of the history and evolution of MISS.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA

    R. Nick Hernandez, Jonathan Nakhla, Rodrigo Navarro-Ramirez & Roger Härtl

Authors
  1. R. Nick Hernandez
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  2. Jonathan Nakhla
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  3. Rodrigo Navarro-Ramirez
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  4. Roger Härtl
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Corresponding author

Correspondence to R. Nick Hernandez .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Frank M. Phillips

  2. Texas Back Institute Texas Health Presbyterian Hospital Plano Scoliosis and Spine Tumor Center, Plano, TX, USA

    Isador H. Lieberman

  3. Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA

    David W. Polly Jr.

  4. Department of Neurological Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL, USA

    Michael Y. Wang

Appendices

Quiz Questions

  1. 1.

    Which of the following is not a surgical objective that has driven the evolution of MISS?

    1. (a)

      Achieve indirect neural decompression

    2. (b)

      Limit tissue disruption

    3. (c)

      Achieve bilateral decompression via a unilateral approach

    4. (d)

      Excessive bony resection resulting in destabilization

  2. 2.

    Minimally invasive techniques to the spine were first developed for treatment of which of the following pathologies?

    1. (a)

      Cervical disc herniation

    2. (b)

      Lumbar disc herniation

    3. (c)

      Lumbar spondylolisthesis

    4. (d)

      Thoracic disc herniation

  3. 3.

    Which of the following comparisons of MI-TLIF versus open TLIF is accurate?

    1. (a)

      Better fusion rates, long-term outcome, and patient satisfaction with MI-TLIF

    2. (b)

      Better fusion rates, long-term outcome, and patient satisfaction with open TLIF

    3. (c)

      Less blood loss and shorter hospital stay with MI-TLIF

    4. (d)

      Less blood loss and shorter hospital stay with open TLIF

  4. 4.

    Automatic patient registration , which significantly improved computer-assisted navigation and facilitates MISS, is a characteristic of which of the following navigation systems?

    1. (a)

      Intraoperative CT

    2. (b)

      Preoperative MRI

    3. (c)

      Preoperative CT

    4. (d)

      Cross-table XR

Answers

  1. 1.

    d

  2. 2.

    b

  3. 3.

    c

  4. 4.

    a

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Hernandez, R.N., Nakhla, J., Navarro-Ramirez, R., Härtl, R. (2019). History and Evolution of Minimally Invasive Spine Surgery. In: Phillips, F., Lieberman, I., Polly Jr., D., Wang, M. (eds) Minimally Invasive Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-19007-1_1

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  • DOI: https://doi.org/10.1007/978-3-030-19007-1_1

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  • Online ISBN: 978-3-030-19007-1

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