Minimally Invasive Wiltse Approaches for Posterolateral Fusion

Abstract

MISS approaches to the spine minimize requisite exposure to reduce morbidity associated with surgery, striving for that balance between minimizing anatomic compromise and optimizing surgical outcome. This chapter deals with a subset of approaches constrained by the posterior segmental muscles, with specific regard to their neurovascular supply. The local anatomy of the back supports an anatomic approach medial or lateral to the neurovascular and tendinous constraints about the superior articular process. Initial discussion addresses the fixed constraints about the articular complex in the back with subsequent attention to the more superficial elements constraining the approach.