Technical Tips for Minimally Invasive Fusion Surgery

Objectives: To introduce minimally invasive surgical (MIS) techniques and to review previous studies about these techniques.Summary of Literature Review: Recent trends indicate an increase in the use of MIS for spinal fusion.According to reports, MIS reduces postoperative morbidity, with surgical outcomes comparable to those of conventional spine surgery.Furthermore, there are reportedly fewer complications and pain after surgery, resulting in a rapid return to everyday life. Materials and Methods: A review of the relevant articles.Results: MIS techniques, such as biportal endoscopy, the use of a tubular retractor, and the anterior approach, have recently become increasingly popular.Access to the intervertebral disc through the intervertebral foramen is a characteristic shared by biportal endoscopy and the use of a tubular retractor.Numerous investigations have demonstrated that procedures employing a tubular retractor yield clinical and radiographic outcomes comparable to those of conventional open spine surgery.Biportal endoscopy is still undergoing clinical investigations, and its safety and efficacy have not yet been established.Anterior approach fusion is mainly used in patients with mild central canal stenosis; thus, its indications are somewhat limited compared to conventional posterior fusion.However, additional decompression after anterior approach fusion allows both direct and indirect decompression to be obtained.Conclusions: With MIS, patients' satisfaction after surgery is high due to the small amount of bleeding during surgery and limited damage to surrounding anatomical structures.However, these MIS techniques have narrow indications, and we must accurately understand the disadvantages and limitations of each technique.