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Philosophy and Biology of Minimally Invasive Spine Surgery

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Minimally Invasive Spine Surgery

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Abstract

The last decades have shown an ongoing progress in minimally invasive spine surgery (MISS). The development and introduction of new surgical instruments, smaller tissue retractors, advancements in microscopy, improvement in medical imaging capability, the sensitivity of C-arm, along with the introduction of intraoperative CT scanning and navigation, have allowed for less soft tissue morbidity and shorter lengths of stay. Multiple studies have demonstrated that MISS is associated with lowering the soft tissue injury, decreasing postoperative pain, and shortening lengths of stay and recovery time. The key to successfully performing MISS procedures is a thorough understanding of various anatomical relationships between soft tissue planes, approach corridors, bony anatomy, and neurological structures. Minimally invasive procedures are technically demanding and require advanced training and mentorship. This chapter focuses on the philosophy and biology of MISS.

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Author information

Authors and Affiliations

  1. Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences, Poizna, Wielkopolska, Poland

    Pawel Glowka

  2. Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL, USA

    Pawel Glowka & Kris Siemionow

  3. Minimally Invasive Spine Center of Excellence, Spine Institute of San Diego, San Diego, CA, USA

    Choll W. Kim

Authors
  1. Pawel Glowka
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  2. Choll W. Kim
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  3. Kris Siemionow
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Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Frank M. Phillips

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

    Isador H. Lieberman

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

    David W. Polly Jr.

  4. Department of Neurological Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL, USA

    Michael Y. Wang

Appendices

Quiz Questions

  1. 1.

    The potential causes of muscle injury are:

    1. (a)

      Dissection, retraction, and nerve injury.

    2. (b)

      Wound exposure and operative time.

    3. (c)

      Wound exposure, operative time, and spinal fusion.

    4. (d)

      All above answers are correct.

  2. 2.

    Which nerve supplies the lumbar multifidus muscle:

    1. (a)

      Medial branch of the dorsal rami of the spinal nerve.

    2. (b)

      Intermediate branch of the dorsal rami of the spinal nerve.

    3. (c)

      Lateral branch of the dorsal rami of the spinal nerve.

    4. (d)

      None of above answers is correct.

  3. 3.

    Which answer includes only the advantages of MISS?

    1. (a)

      Lower infection rates, decreased postoperative pain, shorter length of hospital stay, decreased blood loss, and decreased paraspinal muscle atrophy.

    2. (b)

      Lower infections rates, shorter length of hospital stay, decreased blood loss, decreased paraspinal muscle atrophy, and shorter operative time.

    3. (c)

      Decreased radiation exposure, decreased operative time, decreased postoperative pain, and shorter length of hospital stay.

    4. (d)

      Improvement in spine extension strength, better cosmetic outcomes, and decreased radiation exposure.

Answers

  1. 1.

    d

  2. 2.

    a

  3. 3.

    a

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Glowka, P., Kim, C.W., Siemionow, K. (2019). Philosophy and Biology of Minimally Invasive Spine Surgery. In: Phillips, F., Lieberman, I., Polly Jr., D., Wang, M. (eds) Minimally Invasive Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-19007-1_2

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  • DOI: https://doi.org/10.1007/978-3-030-19007-1_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-19006-4

  • Online ISBN: 978-3-030-19007-1

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