Choice of minimally invasive approaches: A review of unique risks and complications

Ngoc Lam M. Nguyen, Alpesh A. Patel*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter


In the last two decades, spine surgery has witnessed an evolution of minimally invasive procedures. Despite established evidence of long-term efficacy, conventional open surgical approaches are associated with high morbidity that can sometimes mitigate clinical benefits. On the other hand, minimally invasive surgical techniques are purported to minimize soft tissue trauma and, therefore, offer the advantages of decreased blood loss, reduced postoperative pain, shorter hospitalization, facilitate quicker recovery and rehabilitation, and delay progression of adjacent level degeneration and deformity. Advances in minimally invasive technology as well as specialized access instruments and tissue retractors have allowed surgeons to reduce approach-related morbidities by focusing on the pathologic anatomy and preserving normal muscular, ligamentous, and bony structures. However, surgeons who desire to master minimally invasive surgery must overcome a set of unique technical challenges, such as the limited tactile feedback, loss of 3D appreciation and imperfect color representation associated with endoscopic optics, and difficulty with recognizing and managing intraoperative technical problems through smaller surgical windows. There is also a steep learning curve for developing the appropriate surgical manual dexterity to master the specialized instruments necessary to perform minimally invasive spine surgery. As minimally invasive procedures continue to grow, surgeons are also faced with a wide array of surgical approaches and techniques. It, therefore, is paramount that spine surgeons possess a clear understanding of the associated complications that can occur with each approach. More importantly, knowing how to avoid these possible complications and how to manage them is critical to performing safe and successful minimally invasive spine surgery.

Original languageEnglish (US)
Title of host publicationMinimally Invasive Spine Surgery
Subtitle of host publicationSurgical Techniques and Disease Management
PublisherSpringer New York
Number of pages12
ISBN (Electronic)9781461456742
ISBN (Print)9781461456735
StatePublished - Jan 1 2014

ASJC Scopus subject areas

  • Medicine(all)

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