Excellence in spine surgery means preserving the multifidus muscle – and being able to demonstrate success in doing so, according to Choll Kim, MD, PhD, who gave a talk titled "What Does it Mean to be a Minimally Invasive Spine Center of Excellence" on June 13, 2014 at the 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine on June 13, 2014 in Chicago.
"Crushing a muscle, as in the use of non-minimally invasive retractors, is very bad. It causes muscle necrosis, fibrosis, fiber size atrophy, loss of power and systemic inflammation," said Dr. Kim.
While performing MIS is known to preserve the multifidus, another compelling reason to perform MIS transforaminal lumbar interbody fusion is that the deep infection rate is significantly lower than open surgery by nearly 500 percent, according to data from the Scoliosis Research Society, Dr. Kim said.
While this is an example of how to successfully track outcomes in support of MIS surgery, it is not always this easy. "Spine surgeons are fiercely independent, but we have to work together," said Dr. Kim. "We have a lot of data on very few patients – a limited patient population. We need more data. We need to work together through data registries."
"Everyone operates a center of excellence: Technology, training and great practice management those things create a center of excellence. But then you have to measure outcomes and use those outcomes to improve, to truly be excellent," he added.