The Use of Minimally Invasive Techniques in Spinal Surgery: Current Status and Future Directions: Minimally Invasive Techniques in Spinal Surgery

Mian Iftikhar ul Haq; Abdul Munaf Saud; Shaukat Hayat Khan; Tauseef Raza; Abdul Rehman Khan; Syed Abdur Rub Abidi

doi:10.54393/pjhs.v5i10.2312

Authors

Mian Iftikhar ul Haq Department of Neurosurgery, Hayatabad Medical Complex Hospital, Peshawar, Pakistan
Abdul Munaf Saud Department of Orthopedic Surgery, Bahawal Victoria Hospital, Bahawalpur, Pakistan
Shaukat Hayat Khan Department of Orthopedic Surgery, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Combined Military Hospital, Muzaffarabad, Pakistan
Tauseef Raza Department of Orthopedic Surgery, Khyber Medical University Institute of Medical Sciences, Kohat, Pakistan
Abdul Rehman Khan Department of Orthopedics Surgery, Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan
Syed Abdur Rub Abidi Department of Orthopedic Surgery, Jinnah Medical and Dental College, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i10.2312

Keywords:

Minimally Invasive Spinal Surgery, Evolution, Optimization, Future Directions

Abstract

Minimally invasive spine surgeries have come a long way from their open counterparts in recent years, allowing for less tissue stress, smaller incisions, and quicker recoveries. Objectives: To trace the development of minimally invasive spine surgical procedures from their inception to the present day and to find ways to improve and innovate these methods in the future. Methods: This prospective observational study was conducted at the Neurosurgery Department of Lady Reading Hospital-Medical Training Initiative, Peshawar. 230 individuals were progressively enrolled, and a plethora of spinal disorders were recruited as inclusion criteria. This information was gathered by painstakingly capturing demographics, co-morbidities, surgical procedure details and postoperative results. Statistical analysis identifies the trends. Results: The mean age of the study was 54.7 years and male were higher in numbers. Discectomy was the most commonly performed operation with the degenerative disease of the spine accounting for the highest (26.06%). With an average hospital stay of 5.8 days, problems such as Dural tears occurred during the operation in 10.87% of cases. While problems such neighboring segment illness were observed in 6.52% of patients, follow-up demonstrated improved functional results in 65.22% of cases. Variables such as surgical indication and procedure showed significant relationships (p<0.001) according to chi-square testing. Conclusions: It was concluded that minimally invasive spine surgery draws attention to the need for ongoing innovation and research to improve outcomes and overcome technical challenges in the treatment of complex spinal illnesses. This approach offers less invasive treatments with shorter recovery times and fewer complications

References

Spetzger U, Schilling AV, Winkler G, Wahrburg J, König A. The Past, Present and Future of Minimally Invasive Spine Surgery: A Review and Speculative Outlook. Minimally Invasive Therapy & Allied Technologies. 2013 Aug; 22(4): 227-41. doi: 10.3109/13645706.2013.821414.

Goldberg JL, Hussain I, Sommer F, Härtl R, Elowitz E. The Future of Minimally Invasive Spinal Surgery. World Neurosurgery. 2022 Jul; 163: 233-40. doi: 10.1016/j.wneu.2022.03.121.

Martin BI, Mirza SK, Spina N, Spiker WR, Lawrence B, Brodke DS. Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015. Spine. 2019 Mar; 44(5): 369-76. doi: 10.1097/BRS.0000000000002822.

Smith ZA and Fessler RG. Paradigm Changes in Spine Surgery—Evolution of Minimally Invasive Techniques. Nature Reviews Neurology. 2012 Aug; 8(8): 443-50. doi: 10.1038/nrneurol.2012.110.

Skovrlj B, Gilligan J, Cutler HS, Qureshi SA. Minimally Invasive Procedures on the Lumbar Spine. World Journal of Clinical Cases. 2015 Jan; 3(1): 1. doi: 10.12998/wjcc.v3.i1.1.

Sciubba DM, Pennington Z, Colman MW, Goodwin CR, Laufer I, Patt JC et al. Spinal Metastases 2021: A Review of the Current State of the Art and Future Directions. The Spine Journal. 2021 Sep; 21(9): 1414-29. doi: 10.1016/j.spinee.2021.04.012.

Campbell DH, McDonald D, Araghi K, Araghi T, Chutkan N, Araghi A. The Clinical Impact of Image Guidance and Robotics in Spinal Surgery: A Review of Safety, Accuracy, Efficiency, and Complication Reduction. International Journal of Spine Surgery. 2021 Oct; 15(s2): S10-20. doi: 10.14444/8136.

D'Andrea K, Dreyer J, Fahim DK. Utility of Preoperative Magnetic Resonance Imaging Coregistered with Intraoperative Computed Tomographic Scan for the Resection of Complex Tumors of the Spine. World Neurosurgery. 2015 Dec; 84(6): 1804-15. doi: 10.1016/j.wneu.2015.07.072.

Jhala AC and Gajjar SC. Complications and Limitations of Tubular Retractor System in Minimally Invasive Spine Surgery: A Review. Indian Spine Journal. 2020 Jan; 3(1): 34-40. doi: 10.4103/isj.isj_33_19.

Phillips FM, Lieberman IH, Polly Jr DW, Wang MY. Minimally Invasive Spine Surgery: Surgical Techniques and Disease Management. Springer Nature. 2020 Jan. doi: 10.1007/978-3-030-19007-1.

Liao R, Zhang L, Sun Y, Miao S, Chefd'Hotel C. A Review of Recent Advances in Registration Techniques Applied to Minimally Invasive Therapy. Institute of Electrical and Electronics Engineers Transactions on Multimedia. 2013 Feb; 15(5): 983-1000. doi: 10.1109/TMM.2013.2244869.

Patel PD, Canseco JA, Houlihan N, Gabay A, Grasso G, Vaccaro AR. Overview of Minimally Invasive Spine Surgery. World Neurosurgery. 2020 Oct; 142: 43-56. doi: 10.1016/j.wneu.2020.06.043.

Lucio JC, VanConia RB, DeLuzio KJ, Lehmen JA, Rodgers JA, Rodgers WB. Economics of Less Invasive Spinal Surgery: An Analysis of Hospital Cost Differences Between Open and Minimally Invasive Instrumented Spinal Fusion Procedures During the Perioperative Period. Risk Management and Healthcare Policy. 2012 Aug: 5: 65-74. doi: 10.2147/RMHP.S30974.

Whitmore RG, Stephen J, Stein SC, Campbell PG, Yadla S, Harrop JS et al. Patient Comorbidities and Complications After Spinal Surgery: A Societal-Based Cost Analysis. Spine. 2012 May; 37(12): 1065-71. doi: 10.1097/BRS.0b013e31823da22d.

Epstein NE. More Risks and Complications for Elective Spine Surgery in Morbidly Obese Patients. Surgical Neurology International. 2017 Apr; 8: 66. doi: 10.4103/sni.sni_49_17.

Smith ZA and Fessler RG. Paradigm Changes in Spine Surgery—Evolution of Minimally Invasive Techniques. Nature Reviews Neurology. 2012 Aug; 8(8): 443-50. doi: 10.1038/nrneurol.2012.110.

Lewandrowski KU, Bergamashi JP, Telfeian AE, de Carvalho PS, Leon JF. Training and Credentialing Standards for Minimally Invasive Spinal Surgery Techniques: Results of A Survey. Pain Physician. 2023 Jan; 26(1): 29-37. doi: 10.36076/ppj.2023.26.29.

Guo F, Xia C, Wang Z, Wang R, Gao J, Meng Y et al. Nomogram for Predicting the Surgical Difficulty of Laparoscopic Total Mesorectal Excision and Exploring the Technical Advantages of Robotic Surgery. Frontiers in Oncology. 2024 Jan; 14: 1303686. doi: 10.3389/fonc.2024.1303686.

Duan WR, Du Y, Jian F. Risk Factors and Management for Dural Tears in Anterior Surgery for Cervical Ossification of the Posterior Longitudinal Ligament. Global Spine Journal. 2018 May; 8: 169-170.

Pennington Z, Ahmed AK, Molina CA, Ehresman J, Laufer I, Sciubba DM. Minimally Invasive Versus Conventional Spine Surgery for Vertebral Metastases: A Systematic Review of the Evidence. Annals of Translational Medicine. 2018 Mar; 6(6). doi: 10.21037/atm.2018.01.28.

Tschugg A, Hartmann S, Lener S, Rietzler A, Sabrina N, Thomé C. Minimally Invasive Spine Surgery in Lumbar Spondylodiscitis: A Retrospective Single-Center Analysis of 67 Cases. European Spine Journal. 2017 Dec; 26: 3141-6. doi: 10.1007/s00586-017-5180-x.

Patel HA, Cheppalli NS, Bhandarkar AW, Patel V, Singla A. Lumbar Spinal Steroid Injections and Infection Risk After Spinal Surgery: A Systematic Review and Meta-Analysis. Asian Spine Journal. 2022 Dec; 16(6): 947. doi: 10.31616/asj.2021.0164.

Papadimitriou K, Amin AG, Kretzer RM, Sciubba DM, Bydon A, Witham TF et al. Thromboembolic Events and Spinal Surgery. Journal of Clinical Neuroscience. 2012 Dec; 19(12): 1617-21. doi: 10.1016/j.jocn.2012.03.024.

Bhatt F, Orosz L, Yamout T, Good C, Bucci A, Allen B et al. E-Posters. Global Spine Journal. 2023 May; 13(2S): 215S-567S. doi: 10.1177/21925682231166109.

Hermansen E, Austevoll IM, Hellum C, Storheim K, Myklebust TÅ, Aaen J et al. Comparison of 3 Different Minimally Invasive Surgical Techniques for Lumbar Spinal Stenosis: A Randomized Clinical Trial. ournal of the American Medical Association Network Open. 2022 Mar; 5(3): e224291-. doi: 10.1001/jamanetworkopen.2022.4291.