Historically, the ethos of spine surgery has been anchored in exposure: broad visualization, direct identification of anatomy, and the principle that seeing more facilitates safety and efficacy. Yet the experienced surgeon has always known where to find structures rather than waiting for them to reveal themselves. Minimally invasive spine surgery (MISS) makes this cognitive demand total. It replaces wide exposure with technologies that ask the surgeon to operate from a map rather than a direct view.
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Robertson et al. (2026) studied this question.
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