Is minimally invasive surgery a game changer in spinal surgery?

IF 2.3 Q2 ORTHOPEDICS Asian Spine Journal Pub Date : 2024-10-01 Epub Date: 2024-10-22 DOI:10.31616/asj.2024.0337
Sang-Min Park, Ho-Joong Kim, Jin S Yeom
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Abstract

Minimally invasive spine surgery (MISS) has revolutionized the treatment of spinal disorders over the past few decades. This review provides an in-depth analysis of MISS techniques, technologies, outcomes, and future directions. The evolution of MISS techniques-including tubular retractor systems, percutaneous pedicle screw fixation, minimally invasive transforaminal lumbar interbody fusion, lateral lumbar interbody fusion, and endoscopic spine surgery-has expanded the scope of treatable spinal pathologies while minimizing tissue trauma. Technological advancements such as intraoperative navigation, robotics, and augmented reality applications have enhanced precision and capabilities. Clinical evidence supports the efficacy and safety of MISS techniques for various spinal pathologies, demonstrating comparable or superior outcomes to traditional open approaches with reduced tissue trauma, blood loss, and hospital stays. Cost-effectiveness analyses also favor MISS over open techniques. Future directions in MISS include expanding indications, integrating artificial intelligence and machine learning, advancing tissue engineering and biologics, and refining robotic and augmented reality applications. As MISS continues to evolve, it is poised to play an increasingly important role in the treatment of spinal disorders, offering improved patient outcomes with reduced morbidity. However, ongoing rigorous evaluation of new techniques and technologies is crucial to balance potential benefits with associated risks and costs.

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微创手术是否会改变脊柱外科的游戏规则?
过去几十年来,微创脊柱手术(MISS)彻底改变了脊柱疾病的治疗方法。这篇综述深入分析了微创脊柱手术的技巧、技术、成果和未来发展方向。微创脊柱手术(MISS)技术的发展--包括管状牵引器系统、经皮椎弓根螺钉固定、微创经椎间孔腰椎椎间融合术、侧腰椎椎间融合术和内窥镜脊柱手术--扩大了可治疗脊柱病变的范围,同时最大限度地减少了组织创伤。术中导航、机器人技术和增强现实应用等技术进步提高了手术的精确度和能力。临床证据支持 MISS 技术治疗各种脊柱病变的有效性和安全性,其疗效与传统开放式方法相当或更优,组织创伤、失血量和住院时间均有所减少。成本效益分析也显示,MISS 技术优于开放式技术。MISS 的未来发展方向包括扩大适应症、整合人工智能和机器学习、推进组织工程和生物制剂,以及完善机器人和增强现实应用。随着 MISS 技术的不断发展,它将在脊柱疾病治疗中发挥越来越重要的作用,为患者提供更好的治疗效果,同时降低发病率。然而,对新技术和新工艺进行持续严格的评估对于平衡潜在效益与相关风险和成本至关重要。
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来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
期刊最新文献
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