The Role of Minimally Invasive Surgery in the Lumbar Spine

Specific surgical advances of the last several decades have enabled spinal surgeons to increasingly preserve more of the normal tissue in efforts to enhance postoperative results. Improvements in viewing technologies, including microscopy, have been a major step. The development of specialized surgical instruments and implants also have allowed for the design of spine procedures that do not require the traditional extent of tissue dissection. A wide variety of spinal pathologies, such as spinal stenosis, herniated nucleus pulposus, and some forms of spinal instability, may be managed successfully with minimally invasive spine surgery techniques. New skills must be mastered to perform safe and effective minimally invasive spine surgery; these new techniques have an inherent learning curve. However, these procedures can be learned through instruction and rely on many of the same principles that practiced spine surgeons are familiar with. Minimally invasive spine surgery may have the potential to significantly reduce perioperative morbidity. Well-designed clinical studies are still needed, however, to compare the benefits of minimally invasive spine surgery with traditional management.