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Choice of Minimally invasive Approaches: A Review of Unique Risks and Complications

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Minimally Invasive Spine Surgery

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Abstract

In the last two decades, spine surgery has witnessed an evolution of minimally invasive procedures. Despite established evidence of long-term efficacy, conventional open surgical approaches are associated with high morbidity that can sometimes mitigate clinical benefits. On the other hand, minimally invasive surgical techniques are purported to minimize soft tissue trauma and, therefore, offer the advantages of decreased blood loss, reduced postoperative pain, shorter hospitalization, facilitate quicker recovery and rehabilitation, and delay progression of adjacent level degeneration and deformity.

Advances in minimally invasive technology as well as specialized access instruments and tissue retractors have allowed surgeons to reduce approach-related morbidities by focusing on the pathologic anatomy and preserving normal muscular, ligamentous, and bony structures. However, surgeons who desire to master minimally invasive surgery must overcome a set of unique technical challenges, such as the limited tactile feedback, loss of 3D appreciation and imperfect color representation associated with endoscopic optics, and difficulty with recognizing and managing intraoperative technical problems through smaller surgical windows. There is also a steep learning curve for developing the appropriate surgical manual dexterity to master the specialized instruments necessary to perform minimally invasive spine surgery.

As minimally invasive procedures continue to grow, surgeons are also faced with a wide array of surgical approaches and techniques. It, therefore, is paramount that spine surgeons possess a clear understanding of the associated complications that can occur with each approach. More importantly, knowing how to avoid these possible complications and how to manage them is critical to performing safe and successful minimally invasive spine surgery.

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Authors and Affiliations

  1. Department of Orthopaedics and Rehabilitation, Loyola University Medical Center, Maywood, IL, USA

    Ngoc-Lam M. Nguyen MD & Alpesh A. Patel MD, FACS

  2. Department of Orthopaedic Surgery, Northwestern University School of Medicine, 676 N St. Clair Street, Suite 1350, Chicago, IL, USA

    Alpesh A. Patel MD, FACS

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  1. Ngoc-Lam M. Nguyen MD
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  2. Alpesh A. Patel MD, FACS
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Correspondence to Alpesh A. Patel MD, FACS .

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Editors and Affiliations

  1. Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Frank Phillips

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

    Isador Lieberman

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

    David Polly

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Nguyen, NL.M., Patel, A.A. (2014). Choice of Minimally invasive Approaches: A Review of Unique Risks and Complications. In: Phillips, F., Lieberman, I., Polly, D. (eds) Minimally Invasive Spine Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5674-2_36

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  • DOI: https://doi.org/10.1007/978-1-4614-5674-2_36

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  • Online ISBN: 978-1-4614-5674-2

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