Minimally invasive techniques for spine surgery were initiated in the 1980’s and have evolved and improved in the past three decades thanks to technical innovations. Such advances include better imaging techniques (such as fluoroscopy), dilators, smaller retractors, neuromonitoring, and bone graft substitutes. Today, minimally invasive surgery techniques are considered as effective as open surgery techniques to repair the spine. The main reason for using minimally invasive techniques is to minimize the trauma to tissues during surgery, which typically results in fewer complications, less pain, less time spent in the hospital, and faster recovery, all of which are very important outcomes for patients. Therefore, minimally invasive techniques have become the state of the art in back surgery and have replaced open surgeries, whenever it is feasible.
Now, virtually all levels of the spine can be accessed through minimally invasive approaches, making it amenable for use in an increasing number of patients and an increasing number of back problems. Skilled surgeons are now able to use minimally invasive approaches to treat complex disorders, including tumors, deformity, infection, and trauma. \Nevertheless, not all types of surgeries can be performed through minimally invasive techniques and some patients may not be good candidates for minimally invasive spine surgery. In some cases, the disadvantages of the minimally invasive approach may counteract its advantages, making open surgery a better option.
Several types of minimally invasive approaches are available for spinal fusion surgery. These various approaches mainly differ by the way the surgeon accesses the spine to perform the surgery. The choice of the appropriate approach for surgery mainly depends on the patient’s anatomy and the surgeon’s expertise and preference. Regardless of the approach chosen to manage a patient with a spine injury or disorder, the goal of the treatment is always to prevent the development of a neurological deficit, enhance neurological recovery, achieve a stable spine that will allow for appropriate rehabilitation, and prevent post-surgical deformity and pain.