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

William P. Mosenthal, Srikanth N. Divi, Jason L. Dickherber, Michael J. Lee*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter


The goal of minimally invasive spine surgery is to obtain outcomes equivalent or superior to that of open procedures through a less morbid approach that features minimal disruption to the patient’s native anatomy. Tubular retractor systems and microscopes have become staples in the armamentarium of the minimally invasive spine surgeon and, as with any technological innovation, come with their own set of advantages and disadvantages. Working through a smaller surgical footprint makes mastery of the local anatomy of paramount importance. Many of the anatomical structures that surgeons rely on for reference during open approaches are not visible during minimally invasive approaches and can lead to surgeon disorientation. It is crucial that surgeons develop the ability to convert two-dimensional microscopic images to a three-dimensional representation of the surgical field. Minimally invasive spine surgeons have to adjust to the changes in control and tactile feedback afforded by the longer instruments required to work through narrow tubular retractors. Complications that occur during the approach, injury to the dura or vascular structures, for example, can be more difficult to manage within the confines of a minimally invasive approach. Minimally invasive surgeries (MIS) are technically demanding procedures that have a substantial but surmountable learning curve. The onus is on the minimally invasive spinal surgeon to develop a clear understanding of the complications associated with the various minimally invasive approaches and develop the ability to mitigate the risk of complications and manage them if they do occur.

Original languageEnglish (US)
Title of host publicationMinimally Invasive Spine Surgery
Subtitle of host publicationSurgical Techniques and Disease Management
PublisherSpringer International Publishing
Number of pages14
ISBN (Electronic)9783030190071
ISBN (Print)9783030190064
StatePublished - Jan 1 2020


  • ACDF approach
  • ACDF complications
  • ALIF approach
  • ALIF complications
  • ATP approach
  • ATP complications
  • Anterior approach
  • Anterior complications
  • Approach complications
  • Arthrodesis approach
  • Arthrodesis complications
  • AxiaLif approach
  • AxiaLif complications
  • Cervical approach
  • Cervical complications
  • DLIF approach
  • DLIF complications
  • Discectomy approach
  • Discectomy complications
  • Foraminotomy approach
  • Foraminotomy complications
  • Interbody approach
  • Interbody complications
  • LLIF approach
  • LLIF complications
  • Laminoforaminotomy approach
  • Laminoforaminotomy complications
  • Laminotomy approach
  • Laminotomy complications
  • Lumbar approach
  • Lumbar complications
  • MIS approach
  • MIS complications
  • Microdiscectomy approach
  • Microdiscectomy complications
  • OLIF approach
  • OLIF complications
  • PLIF approach
  • PLIF complications
  • Posterior approach
  • Posterior complications
  • Presacral approach
  • Presacral complications
  • Retropleural approach
  • Retropleural complications
  • TLIF approach
  • TLIF complications
  • Thoracic approach
  • Thoracic complications
  • Transforaminal approach
  • Transforaminal complications
  • Transpleural approach
  • Transpleural complications
  • Transpsoas approach
  • Transpsoas complications
  • XLIF approach
  • XLIF complications

ASJC Scopus subject areas

  • Medicine(all)


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