Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Minimally Invasive Spine Surgery 19 articles


Minimally Invasive versus Open Posterior Lumbar Interbody Fusion: A Systematic Review

Gursukhman S. Sidhu MBBS, Erik Henkelman BSE, Alexander R. Vaccaro MD, PhD, Todd J. Albert MD, Alan Hilibrand MD, D. Greg Anderson MD, Jeffrey A. Rihn MD

Although conventional open posterior lumbar interbody fusion (open PLIF) is efficacious in management of lumbar spinal instability, concerns exist regarding lengthy hospital stays, blood loss, and postoperative complications. Minimally invasive posterior lumbar interbody fusion (MIS PLIF) may be able to address these concerns, but the research on this topic has not been systematically reviewed.

Is Circumferential Minimally Invasive Surgery Effective in the Treatment of Moderate Adult Idiopathic Scoliosis?

Neel Anand MD, MchOrth, Eli M. Baron MD, Babak Khandehroo MD

Outcomes for minimally invasive scoliosis correction surgery have been reported for mild adult scoliosis. Larger curves historically have been treated with open surgical procedures including facet resections or posterior column osteotomies, which have been associated with high-volume blood loss. Further, minimally invasive techniques have been largely reported in the setting of degenerative scoliosis.

Does Less Invasive Spine Surgery Result in Increased Radiation Exposure? A Systematic Review

Elizabeth Yu MD, Safdar N. Khan MD

Radiation exposure to patients and spine surgeons during spine surgery is expected. The risks of radiation exposure include thyroid cancer, cataracts, and lymphoma. Although imaging techniques facilitate less invasive approaches and improve intraoperative accuracy, they may increase radiation exposure.

Minimally Invasive Versus Open Sacroiliac Joint Fusion: Are They Similarly Safe and Effective?

Charles G. T. Ledonio MD, David W. Polly MD, Marc F. Swiontkowski MD

The sacroiliac joint has been implicated as a source of chronic low back pain in 15% to 30% of patients. When nonsurgical approaches fail, sacroiliac joint fusion may be recommended. Advances in intraoperative image guidance have assisted minimally invasive surgical (MIS) techniques using ingrowth-coated fusion rods; however, how these techniques perform relative to open anterior fusion of the sacroiliac joint using plates and screws is not known.

Complications Associated With the Initial Learning Curve of Minimally Invasive Spine Surgery: A Systematic Review

Joseph A. Sclafani MD, Choll W. Kim MD, PhD

There is an inherently difficult learning curve associated with minimally invasive surgical (MIS) approaches to spinal decompression and fusion. The association between complication rate and the learning curve remains unclear.

Disc Space Preparation in Transforaminal Lumbar Interbody Fusion: A Comparison of Minimally Invasive and Open Approaches

Jeffrey A. Rihn MD, Sapan D. Gandhi BS, Patrick Sheehan BBA, Alexander R. Vaccaro MD, PhD, Alan S. Hilibrand MD, Todd J. Albert MD, David G. Anderson MD

Minimally invasive surgical (MIS) approaches to transforaminal lumbar interbody fusion (TLIF) have been developed as an alternative to the open approach. However, concerns remain regarding the adequacy of disc space preparation that can be achieved through a minimally invasive approach to TLIF.

Minimally Invasive Surgical Approaches in the Management of Tuberculosis of the Thoracic and Lumbar Spine

Nitin Garg MCh, MS, MRCS(Edin), Renuka Vohra DNB, DMRD

Spinal tuberculosis is the most common form of skeletal tuberculosis. Various approaches have been described for surgical management of spinal tuberculosis, but many entail wide exposures with attendant morbidity; whether minimally invasive surgical (MIS) approaches are suitable is unknown.

Comparative Outcomes of Minimally Invasive Surgery for Posterior Lumbar Fusion: A Systematic Review

Christina L. Goldstein MD, FRCSC, Kevin Macwan BHSc, Kala Sundararajan BSc, MSc, Y. Raja Rampersaud MD, FRCSC

Although minimally invasive surgical (MIS) approaches to the lumbar spine for posterior fusion are increasingly being utilized, the comparative outcomes of MIS and open posterior lumbar fusion remain unclear.

Indirect Decompression of Lumbar Stenosis With Transpsoas Interbody Cages and Percutaneous Posterior Instrumentation

Antonio E. Castellvi MD, Thomas W. Nienke MD, German A. Marulanda MD, Ryan D. Murtagh MD, Brandon G. Santoni PhD

The minimally invasive lateral transpsoas retroperitoneal approach to address lumbar stenosis offers advantages to traditional approaches, including sparing of the AP annulus and longitudinal ligament and less risk to the peritoneal contents and retroperitoneal vascular structures. Few studies have presented longitudinal measures of radiographic indirect decompression and relief of pain and restoration of function using the lateral approach to spine fusion.

Minimally Invasive Surgical Techniques in Adult Degenerative Spinal Deformity: A Systematic Review

Konrad Bach MD, Amir Ahmadian MD, Armen Deukmedjian MD, Juan S. Uribe MD

Minimally invasive surgery (MIS) approaches have the potential to reduce procedure-related morbidity when compared with traditional approaches. However, the magnitude of radiographic correction and degree of clinical improvement with MIS techniques for adult spinal deformity remain undefined.

Elderly Patients Have Similar Outcomes Compared to Younger Patients After Minimally Invasive Surgery for Spinal Stenosis

Ilyas S. Aleem MD, Y. Raja Rampersaud MD, FRCS(C)

Older patients undergo surgery for lumbar spinal stenosis in great numbers, but as a result of substantial diagnostic and surgical heterogeneity, the impact of age on results after surgery is poorly defined.

Same-day Discharge After Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Series of 808 Cases

Walter W. Eckman MD, Lynda Hester PT, Michelle McMillen RN

The versatility of transforaminal lumbar interbody fusion (TLIF) allows fusion at any level along with any necessary canal decompression. Unilateral TLIF with a single interbody device and unilateral pedicle fixation has proven effective, and minimally invasive techniques have shortened hospital stays. Reasonable questions have been raised, though, about whether same-day discharge is feasible and safe after TLIF surgery.

Does Minimally Invasive Transsacral Fixation Provide Anterior Column Support in Adult Scoliosis?

Neel Anand MD, MchOrth, Eli M. Baron MD, Babak Khandehroo MD

Spinal fusion to the sacrum, especially in the setting of deformity and long constructs, is associated with high complication and pseudarthrosis rates. Transsacral discectomy, fusion, and fixation is a minimally invasive spine surgery technique that provides very rigid fixation. To date, this has been minimally studied in the setting of spinal deformity correction.

What Is the Learning Curve for Robotic-assisted Pedicle Screw Placement in Spine Surgery?

Xiaobang Hu MD, PhD, Isador H. Lieberman MD, MBA, FRCSC

Some early studies with robotic-assisted pedicle screw implantation have suggested these systems increase accuracy of screw placement. However, the relationship between the success rate of screw placement and the learning curve of this new technique has not been evaluated.

Is the Lateral Transpsoas Approach Feasible for the Treatment of Adult Degenerative Scoliosis?

Carlos Castro MD, Leonardo Oliveira BS, Rodrigo Amaral MD, Luis Marchi MS, Luiz Pimenta MD, PhD

Lumbar degenerative scoliosis is a common condition in the elderly. Open traditional surgical approaches are associated with high-morbidity complication rates. Less invasive options may carry fewer risks in this patient population. A minimally disruptive lateral transpsoas retroperitoneal technique to accomplish interbody fusion was developed to avoid the morbidity of traditional open surgery, but this approach as an anterior stand-alone construction has not been reported yet for the treatment of adult degenerative scoliosis.

Changes in the Adjacent Segment 10 Years After Anterior Lumbar Interbody Fusion for Low-Grade Isthmic Spondylolisthesis

Kyung-Chul Choi MD, PhD, Jin-Sung Kim MD, PhD, Hyeong-Ki Shim MD, Yong Ahn MD, PhD, Sang-Ho Lee MD, PhD

Adjacent segment degeneration is a long-term complication of arthrodesis. However, the incidence of adjacent segment degeneration varies widely depending on the patient’s age and underlying disease and the fusion techniques and diagnostic methods used.

Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis and Degenerative Spondylosis: 5-year Results

Yung Park MD, Joong Won Ha MD, Yun Tae Lee MD, Na Young Sung MS

Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported.

Does Minimally Invasive Surgery Have a Lower Risk of Surgical Site Infections Compared With Open Spinal Surgery?

Wen Wei Gerard Ee MBBS, Wen Liang Joel Lau, William Yeo (Manips), Yap Bing BSc, MSc, PhD, MBBS, M Med (Surg), FRCS (Edin & Glasg), FAMS, Wai Mun Yue MBBS, FRCS (Edin), FAMS (Orth Surg)

Surgical site infection (SSI) ranges from 1.9% to 5.5% in most large series. Minimally invasive surgery (MIS) has been postulated to reduce SSI rates.