History and Evolution of Minimally Invasive Spine Surgery

  • R. Nick HernandezEmail author
  • Jonathan Nakhla
  • Rodrigo Navarro-Ramirez
  • Roger Härtl


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.


Minimally invasive spine surgery Tubular spine surgery History of spine surgery Evolution of spine surgery Technology in spine surgery 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • R. Nick Hernandez
    • 1
    Email author
  • Jonathan Nakhla
    • 1
  • Rodrigo Navarro-Ramirez
    • 1
  • Roger Härtl
    • 1
  1. 1.Department of NeurosurgeryWeill Cornell Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian HospitalNew YorkUSA

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