Minimally invasive spine surgery (MISS) remains somewhat of an enigma in definition. Over the past decades numerous innovations in multiple medical specialties, anesthesia pain, interventional radiology, orthopaedics and neurosurgery, have touted advances in MISS techniques. While confusion continues to cloud a precise definition of MISS, driving forces including physicians, industry and, most importantly, patients stimulate our need to know more regarding the indications, complications and anticipated outcomes. Pain reduction, reduced soft-tissue damage and ultimately improved patient function are motivating factors. Recent contributions to the literature have documented a reduction in inflammatory mediators, a decrease in muscle atrophy and an increase in muscle strength after MISS. However, Level I data (prospective randomized control trials), comparing MISS with open techniques, remain limited with respect to improving patient outcomes. In summary, the value of MISS is more than surgeon assumption or a marketing whim. In fact, the merits of MISS are clearly suggested by review of recent meta-analyses and available randomized control trials.

Orthopedics International Division of Spine Surgery Washington

Minimally invasive spine surgery

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