Employing minimally invasive surgical techniques can significantly improve intraoperative blood loss, postoperative pain, surgical morbidity and return to function, according to an article published in Spine.
After conducting a literature review, Kim Choll, MD, PhD, of the Spine Institute of San Diego, found that the midline posterior approach to lumbar decompression and fusion can put the patient at risk for complications because the tendon origin of the multifidus muscle is detached, the surgical corridor is wide and significant muscle crush injury occurs when the surgeon uses self-retaining retractors. These events all lead to changes in muscle physiology and function.
The minimally invasive surgical approach is performed using table-mounted tubular retractors focusing on surgical dissection to a narrow corridor directly over the surgical target site. The surgeon selects the surgical corridor on the basis of anatomic planes, which avoids injury to the musculotendinous complex and the neurovascular bundle.
Minimally invasive surgery is technically demanding, according to the article, and a significant complication rate has been observed during the initial learning curve of the procedures.
Read the abstract for "Scientific Basis of Minimally Invasive Spine Surgery: Prevention of Multifidus Muscle Injury During Posterior Lumbar Surgery."
Read other coverage on spine surgery:
- Study: Nucleoplasty May Not Be An Effective Procedure
- Study Shows Minimally Invasive Spine Decompression Effective for Lumbar Spinal Stenosis
- Study: Stand-Alone Anterior Carbon I/F Cage for ALIF a Safe Procedure
After conducting a literature review, Kim Choll, MD, PhD, of the Spine Institute of San Diego, found that the midline posterior approach to lumbar decompression and fusion can put the patient at risk for complications because the tendon origin of the multifidus muscle is detached, the surgical corridor is wide and significant muscle crush injury occurs when the surgeon uses self-retaining retractors. These events all lead to changes in muscle physiology and function.
The minimally invasive surgical approach is performed using table-mounted tubular retractors focusing on surgical dissection to a narrow corridor directly over the surgical target site. The surgeon selects the surgical corridor on the basis of anatomic planes, which avoids injury to the musculotendinous complex and the neurovascular bundle.
Minimally invasive surgery is technically demanding, according to the article, and a significant complication rate has been observed during the initial learning curve of the procedures.
Read the abstract for "Scientific Basis of Minimally Invasive Spine Surgery: Prevention of Multifidus Muscle Injury During Posterior Lumbar Surgery."
Read other coverage on spine surgery:
- Study: Nucleoplasty May Not Be An Effective Procedure
- Study Shows Minimally Invasive Spine Decompression Effective for Lumbar Spinal Stenosis
- Study: Stand-Alone Anterior Carbon I/F Cage for ALIF a Safe Procedure