spinal surgeries. 10–14 Because minimally invasive surgery may reduce soft-tissue trauma, intraoperative blood loss, and surgical site infections, patients may experience reduced postoperative pain and narcotic consumption and more rapid mobilization. While yet unproven, these factors may be especially important in the setting of the medically compromised patient. In the study by Rosen et al. 17 50 patients older than 75 years with significant medical comorbidities underwent minimally invasive spinal surgery for spinal canal decompression. While the study had no
Michael Y. Wang and Praveen V. Mummaneni
Albert P. Wong, Rishi R. Lall, Nader S. Dahdaleh, Cort D. Lawton, Zachary A. Smith, Ricky H. Wong, Michael J. Harvey, Sandi Lam, Tyler R. Koski and Richard G. Fessler
patients with ID-EM tumors are treated successfully with resection of the lesion and decompression of associated neural structures. Traditional open surgical approaches use a lengthy midline incision, subperiosteal dissection of the paraspinal muscles, bilateral laminectomies, and intradural tumor resection. Previous series on open resection of ID-EM tumors have reported high rates of gross-total resection (GTR) with minimal long-term neurological deficit. 13–23 In recent years, minimally invasive surgery (MIS) approaches have become increasingly popular for treatment
Angelo Franzini, Giovanni Broggi, Domenico Servello, Ivano Dones and Maria Grazia Pluchino
I n the last decade, minimally invasive surgery for carpal tunnel syndrome has gained increasing popularity among neurosurgeons and orthopedic surgeons. 1, 3, 5, 12–15, 17 The aim of the various procedures is the early use of the operated hand and the decrease of side effects caused by palmar incision and scar. 9 Nevertheless, some problems and controversies still surround the available minimally invasive procedures. 3, 6 Incomplete section of the ligament may occur distally when blind procedures are performed. Endoscopic procedures may cause a certain rate
Michael Y. Wang and Spencer Block
removal. However, the bone drilling could render this area unusable for internal spinal fixation or pedicle screw placement. For minimally invasive surgery or percutaneous surgery, this problem could be compounded by a lack of exposure and visualization, making object retrieval that much more complicated. We describe here a case in which 2 Jamshidi needles broke during percutaneous pedicle screw cannulation but were successfully retrieved also using a percutaneous technique. Illustrative Case History and Examination This 37-year-old woman presented with
Paul Park, Kai-Ming Fu, Robert K. Eastlack, Stacie Tran, Gregory M. Mundis Jr., Juan S. Uribe, Michael Y. Wang, Khoi D. Than, David O. Okonkwo, Adam S. Kanter, Pierce D. Nunley, Neel Anand, Richard G. Fessler, Dean Chou, Mark E. Oppenlander, Praveen V. Mummaneni and the International Spine Study Group
retrospectively queried. Inclusion criteria for the database included a diagnosis of ASD in addition to age ≥ 18 years and one of the following: coronal Cobb angle > 20°, SVA > 5 cm, PT > 20°, or PI-LL mismatch > 10°. Patients with a minimum of 2 years’ follow-up were included. Surgical treatment consisted of either a circumferential minimally invasive surgery (cMIS) or hybrid surgery consisting of a minimally invasive anterior or lateral surgery combined with open posterior surgery. A total of 223 patients were identified. Based on postoperative optimal spinopelvic parameters
Paul Park, Michael Y. Wang, Virginie Lafage, Stacie Nguyen, John Ziewacz, David O. Okonkwo, Juan S. Uribe, Robert K. Eastlack, Neel Anand, Raqeeb Haque, Richard G. Fessler, Adam S. Kanter, Vedat Deviren, Frank La Marca, Justin S. Smith, Christopher I. Shaffrey, Gregory M. Mundis Jr. and Praveen V. Mummaneni
effects with circumferential minimally invasive correction techniques for adult scoliosis: analysis of radiological outcomes over a 7-year experience . Neurosurg Focus 36 : 5 E14 , 2014 2 Anand N , Baron EM , Khandehroo B , Kahwaty S : Long-term 2- to 5-year clinical and functional outcomes of minimally invasive surgery for adult scoliosis . Spine (Phila Pa 1976) 38 : 1566 – 1575 , 2013 3 Anand N , Baron EM , Thaiyananthan G , Khalsa K , Goldstein TB : Minimally invasive multilevel percutaneous correction and fusion for adult
Paul Park, Kai-Ming Fu, Praveen V. Mummaneni, Juan S. Uribe, Michael Y. Wang, Stacie Tran, Adam S. Kanter, Pierce D. Nunley, David O. Okonkwo, Christopher I. Shaffrey, Gregory M. Mundis Jr., Dean Chou, Robert Eastlack, Neel Anand, Khoi D. Than, Joseph M. Zavatsky, Richard G. Fessler and the International Spine Study Group
A dult spinal deformity (ASD) can cause significant pain and disability. When the deformity is refractory to medical management, spinal deformity surgery can effectively improve pain and function. 14 Presently, there are many options for the surgical treatment of ASD, including minimally invasive surgery (MIS). 2 , 4 , 9 , 10 , 16 , 17 The potential advantages of MIS primarily reflect a significantly diminished exposure-related morbidity resulting in decreased bleeding, length of stay, and pain, and possibly faster recovery. Initial applications of MIS for ASD
Lee A. Tan, Manish K. Kasliwal, Joshua Wewel, Ricardo B. V. Fontes and John E. O'Toole
Schwannomas are the most common intradural-extramedullary spinal tumors, with an estimated incidence of 3 to 10 cases per 100,000 people. With continued advances in minimally invasive surgery (MIS) over recent years, MIS techniques have been utilized by spine surgeons in the resection of intradural spinal neoplasms with favorable surgical results and clinical outcomes. This video demonstrates a rare case of symptomatic, synchronous, same-level lumbar intradural-extramedullary neoplasm and acute disc herniation, both of which were successfully treated using a single MIS approach. Surgical pearls and nuances are discussed to better delineate technique and minimize potential complications.
The video can be found here: http://youtu.be/78ibbicBRUk.
Robert F. Heary and Michael G. Kaiser
G oldstein et al. performed a systematic review of the literature and a metaanalysis of the study results comparing acute perioperative outcomes and adverse event rates of minimally invasive surgery (MIS) versus open transforaminal lumbar interbody fusion (TLIF)/posterior lumbar interbody fusion (PLIF) surgery for degenerative lumbar disease. 1 The authors also summarized data pertaining to patient-reported outcomes, fusion status, and reoperation rates. From 3301 papers, 26 studies met the inclusion criteria for this analysis. Only 1 prospective
Jon Kimball, Andrew Yew and Daniel C. Lu
Symptomatic disc herniation is a common indication for spinal operations. The open microscopic discectomy has been the traditional method of addressing this pathology, but minimally invasive techniques are increasingly popular.
Potential advantages of the MIS microdiscectomy approach include decreased muscle and soft tissue disruption, shorter length of stay and decreased postoperative pain. Here we demonstrate an MIS microdiscectomy on a 24-year-old female with a left L-4 and L-5 radiculopathy secondary to a large L4–5 disc herniation.
The video can be found here: http://youtu.be/aXyZ2FJMh2s.