Summary of Key Points Patient positioning is paramount for a successful procedure. Triggered directional electromyography findings should guide retractor placement anterior to the femoral nerve for the transpsoas approach. Open (expanded) retractor time should be minimized as much as possible…
Summary of Key Points Anterior lumbar interbody fusion (ALIF) provides a biomechanically sound structural intervertebral arthrodesis with a large fusion surface area. ALIF may indirectly decompress the exiting nerve roots by increasing the neural foraminal height. ALIF allows for improved…
Summary of Key Points Minimally invasive fusion options have been shown to have similar complication rates compared with their open counterparts while providing similar or improved clinical outcomes, such as decreased postoperative pain, operative times, length of hospitalization, and blood…
Summary of Key Points Endoscopic surgery of the lumbar spine is an advanced form of minimally invasive surgery that is gaining worldwide popularity. Several studies have shown endoscopic surgery of the lumbar spine to be just as effective as and…
Summary of Key Points Fully endoscopic surgical approaches to the cervical spine include anterior and posterior approaches. Anterior endoscopic cervical spine surgery approaches include anterior cervical discectomy and anterior transcorporal discectomy. Posterior endoscopic cervical spine surgery approaches include posterior cervical…
Summary of Key Points The fundamentals of minimally invasive surgery (MIS) techniques involve minimal muscle dissection and soft tissue trauma, and avoidance of detachment of the osteoligamentous structures, which may help preserve stabilizing structures; while reducing operative time, blood loss,…
Summary of Key Points Minimally invasive spine surgery has gained popularity. It may be used for decompression and stabilization of all segments of the spine and spinal cord. The evolution of minimally invasive spine techniques includes more historical surgical approaches,…
Summary of Key Points Lumbar total disc replacement (TDR) has been studied extensively since its initial use in the 1980s in Europe. Results of long-term follow-up studies in Europe as well as multiple prospective, randomized trials in the United States…
Summary of Key Points Semirigid spine stabilization system refers to a class of spinal fixation strategies that promote segmental load-sharing while controlling abnormal motion, thereby theoretically reducing the risk of adjacent level degeneration and pseudoarthrosis. Semirigid systems may be subdivided…
Summary of Key Points In minimal access surgery, there is a temptation to rely more on fluoroscopy than direct visualization of the pedicle screw entry point. Such reliance quickly drives an upsurge in radiation exposure. The “mini-open” approach allows direct…