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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2015; 3(1): 1-9
Published online Jan 16, 2015. doi: 10.12998/wjcc.v3.i1.1
Minimally invasive procedures on the lumbar spine
Branko Skovrlj, Jeffrey Gilligan, Holt S Cutler, Sheeraz A Qureshi
Branko Skovrlj, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
Jeffrey Gilligan, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, United States
Holt S Cutler, Sheeraz A Qureshi, Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
Author contributions: Skovrlj B, Gilligan J, Cutler HS and Qureshi SA contributed equally towards data collection, literature review, composition of manuscript, final drafting and editing; all authors approve to the submission.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sheeraz A Qureshi, MD, MBA, Department of Orthopaedics, Ichan School of Medicine at Mount Sinai, 5 East 98th Street, Box 1188, New York, NY 10029, United States. heeraz.qureshi@mountsinai.org
Telephone: +1-212-2413909 Fax: +1-212-5346202
Received: July 28, 2014
Peer-review started: July 29, 2014
First decision: September 16, 2014
Revised: October 29, 2014
Accepted: October 31, 2014
Article in press: December 23, 2014
Published online: January 16, 2015
Abstract

Degenerative disease of the lumbar spine is a common and increasingly prevalent condition that is often implicated as the primary reason for chronic low back pain and the leading cause of disability in the western world. Surgical management of lumbar degenerative disease has historically been approached by way of open surgical procedures aimed at decompressing and/or stabilizing the lumbar spine. Advances in technology and surgical instrumentation have led to minimally invasive surgical techniques being developed and increasingly used in the treatment of lumbar degenerative disease. Compared to the traditional open spine surgery, minimally invasive techniques require smaller incisions and decrease approach-related morbidity by avoiding muscle crush injury by self-retaining retractors, preventing the disruption of tendon attachment sites of important muscles at the spinous processes, using known anatomic neurovascular and muscle planes, and minimizing collateral soft-tissue injury by limiting the width of the surgical corridor. The theoretical benefits of minimally invasive surgery over traditional open surgery include reduced blood loss, decreased postoperative pain and narcotics use, shorter hospital length of stay, faster recover and quicker return to work and normal activity. This paper describes the different minimally invasive techniques that are currently available for the treatment of degenerative disease of the lumbar spine.

Keywords: Minimally invasive surgery, Spine surgery, Lumbar spine, Degenerative disease, Interbody fusion, Posterolateral fusion, Decompression, Indirect decompression techniques

Core tip: Degenerative disease of the lumbar spine is a common and increasingly prevalent condition that is often implicated as the primary reason for chronic low back pain and the leading cause of disability in the western world. Compared to the traditional open spine surgery, minimally invasive techniques require smaller incisions and decrease approach-related morbidity. The benefits of minimally invasive surgery over traditional open surgery include reduced blood loss, decreased postoperative pain and narcotics use, shorter hospital length of stay, faster recovery and quicker return to work and normal activity.