The past, present and future of minimally invasive spine surgery: A review and speculative outlook

Abstract

In the last 25 years of spinal surgery, tremendous improvements have been made. The development of smart technologies with the overall aim of reducing surgical trauma has resulted in the concept of minimally invasive surgical techniques. Enhancements in microsurgery, endoscopy and various percutaneous techniques, as well as improvement of implant materials, have proven to be milestones. The advancement of training of spine surgeons and the integration of image guidance with precise intraoperative imaging, computer- and robot-assisted treatment modalities constitute the era of reducing treatment morbidity in spinal surgery. This progress has led to the present era of preserving spinal function. The promise of the continuing evolution of spinal surgery, the era of restoring spinal function, already appears on the horizon. The current state of minimally invasive spine surgery is the result of a long-lasting and consecutive development of smart technologies, along with stringent surgical training practices and the improvement of instruments and techniques. However, much effort in research and development is still mandatory to establish, maintain and evolve minimally invasive spine surgery. The education and training of the next generation of highly specialized spine surgeons is another key point. This paper will give an overview of surgical techniques and methods of the past 25 years, examine what is in place today, and suggest a projection for spine surgery in the coming 25 years by drawing a connection from the past to the future.

Thoracolumbar interfascial plane (TLIP) block: a pilot study in volunteers

“…15,16 Further optimization of care may be possible by using the novel TLIP injection to provide focused regional anesthesia to limit postoperative complications associated with pain and opioid analgesia. In future, the authors expect to study the use of TLIP as the regional anesthesia component of an enhanced surgical recovery protocol for selected patients having single-level lumbar spine surgery.…”

Pedicle-Lengthening Osteotomy for the Treatment of Lumbar Spinal Stenosis: Pre-Clinical Study of Novel Orthopedic Devices

“…Then 4 samples were tested after carrying out a bilateral pedicle-lengthening of the L 4 pedicles by 4.5 mm, while the other 4 samples were tested after lengthening of the L 5 pedicles by 4.5 mm. And then, all 8 samples were tested again after bilateral pedicle-lengthening on both L 4 and L 5 . In all cases, lengthening was performed using the methodology developed for clinical applications.…”

“…Surgical treatment has been increasingly used in patients of this category [2,3], which is associated, among other factors, with the active implementation into clinical practice of minimally invasive technologies [4,5] capable of safe the normal anatomy of the adjacent soft tissues. Since recently, the indications for surgical treatment of various spine disorders have been expanded due to the reduced risk of surgical complications, blood loss, infections, and "physiological stress".…”

“…Thus, since recently there has been a notable growth of the market of implants and surgical instruments for spine surgery [5].…”

Novel placement of cortical bone trajectory screws in previously instrumented pedicles for adjacent-segment lumbar disease using CT image-guided navigation

“…Minimally invasive surgical techniques provide multiple advantages, which include less tissue trauma and less recovery time. 19,23 Recently, minimally invasive surgery has been coupled with advancements in image-guided technologies. 12 In this study, we combine neuronavigation and CBT to treat patients with symptomatic ASLD.…”