History and advances in spinal neurosurgery

Insight into the historic contributions made to modern-day spine surgery provides context for understanding the monumental accomplishments comprising current techniques, technology, and clinical success. Only during the last century did surgical growth occur in the treatment of spinal disorders. With that growth came a renaissance of innovation, particularly with the evolution of spinal instrumentation and fixation techniques. In this article, the authors capture some of the key milestones that have led to the field of spine surgery today, with an emphasis on the historical advances related to instrumentation, navigation, minimally invasive surgery, robotics, and neurosurgical training.

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Evolution of the lateral extracavitary approach to the spine

Neurosurgical FOCUS ◽

10.3171/foc.2004.16.1.13 ◽

2004 ◽

Vol 16 (1) ◽

pp. 1-3 ◽

Cited By ~ 7

Author(s):

Jason Lifshutz ◽

Zvi Lidar ◽

Dennis Maiman

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Vertebral Body ◽

Invasive Surgery ◽

Spinal Surgery ◽

Current Practice ◽

Evolutionary Change ◽

Spinal Disorders ◽

Alternative Approaches ◽

Spine Disorders

The development of alternative approaches to spine disorders marked an evolutionary change in the methods by which surgeons address diseases that affect the ventral portion of the spine. From the advent of spinal surgery until quite recently, physicians used posterior approaches almost exclusively for the treatment of all pathological processes. Surgeons subsequently became frustrated and disenchanted with outcomes of patients with anterior vertebral body disease when these procedures were applied. This sentiment is best reflected in the surgical thought related to Pott disease. In this paper, the authors chart the development of an influential approach to the spine that is designed to address these issues: the lateral extracavitary approach. They trace its origins to early precursor procedures and follow its use in current practice for the treatment of a variety of spinal disorders. They also examine its applications, role, and continued importance in the age of minimally invasive surgery.

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The Endoscopic Approach to Lumbar Discectomy, Fusion, and Enhanced Recovery: A Review

Global Spine Journal ◽

10.1177/2192568219884913 ◽

2020 ◽

Vol 10 (2_suppl) ◽

pp. 65S-69S

Author(s):

Jason I. Liounakos ◽

Michael Y. Wang

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Spine Surgery ◽

Invasive Surgery ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Endoscopic Spine Surgery ◽

Regulatory Constraints ◽

Current State ◽

Spine Care

Study Design: Review. Objectives: To review the current state of endoscopic spine surgery with regard to discectomy, interbody fusion, and combination with Enhanced Recovery After Surgery programs in order to evaluate its relevance to the future of spine care. Methods: A review of the literature and expert opinion is used to accomplish the objectives. Results: The greatest strength of endoscopic spine surgery lies in its adherence to the basic tenets of minimally invasive surgery and its innate compatibility with Enhanced Recovery After Surgery programs, which aim to improve outcomes and reduce health care costs. The greatest challenge faced is the unique surgical skill set and significant learning curve. Conclusions: Endoscopic spine surgery strives to achieve the core goals of minimally invasive surgery, while reducing cost and enhancing quality. In a healthcare market that is becoming increasingly burdened by cost and regulatory constraints, the utilization of endoscopy may become more widespread in the coming years.

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Outcome of minimal invasive surgery approach for spine infection: a systematic review

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195030 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4422

Author(s):

Ketut Gede Mulyadi Ridia

Keyword(s):

Systematic Review ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Spine Surgery ◽

Invasive Surgery ◽

Minimal Invasive Surgery ◽

Minimal Invasive ◽

Spine Infection ◽

Minimally Invasive Spine

The concept of minimally invasive surgery has gained increasing popularity in the last several decades, are being introduced as an alternative to limit the surgical complications while achieving best possible outcome. While minimally invasive spine surgery holds promise for lower blood loss, faster patient recovery, shorter hospital stays, and the potential to transition procedures to the ambulatory setting, safety in spinal surgery remains paramount and has (appropriately) tempered some of the enthusiasm for the results of aggressive early adapters. Until now, there has been no literature summarizing the evidence of MIS outcome in treating spondylitis TB of the bone. The purpose of this systematic review was to investigate the outcome of minimal invasive surgery approach for spine infection. authors comprehensively searched PubMed, EMBASE, and Cochrane Library to search for studies about minimally invasive surgery as management of tuberculous spondylitis up to June 7th, 2019. The selection of appropriate studies was performed by independent investigators based on PRISMA guideline. Given the limited number of studies, there was no restriction in terms of patient’s demographics, the specific minimal invasive surgical method, and publication status. Authors identified the method for minimally invasive approach and open approach, the functional outcome, intraoperative outcome, radiological outcome, length of stay, follow up period, and complication. Authors found 81 articles from database. After evaluating full text, 8 articles (346 patients) were found to be eligible. More than 110 patients were treated with open spine surgery, while more than 270 patients were treated using minimally invasive spine surgery the minimal invasive methods were posterior pedicle screws fixation, plate fixation, lateral nail bar fixation, and bilateral pedicle screw fixation. The visualization methods include C-arm fluoroscopy, X-ray fluoroscopy. The follow-up period ranges from 1 to 40 months. The functional outcome were found to be satisfying with minimal complications. MIS yielded satisfactory result in comparison to conventional open surgery for spine infection. More long term future studies should be conducted to in order to search for more solid evidence regarding this claim.

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20 Spine surgery, for older patients minimally invasive Minimally invasive spine surgery (MIS) Minimally Invasive Surgery in the Aging Spine

Spine Surgery in an Aging Population ◽

10.1055/b-0040-177402 ◽

2020 ◽

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Spine Surgery ◽

Invasive Surgery ◽

Older Patients ◽

Minimally Invasive Spine Surgery ◽

Aging Spine ◽

Minimally Invasive Spine

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A synopsis of current practices in minimally invasive surgery for adult spinal deformity

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20172870 ◽

2017 ◽

Vol 3 (4) ◽

pp. 643

Author(s):

Aniruddh V. Agrawal ◽

Vinod A. Agrawal ◽

Adit A. Singhal ◽

Adit Maniar

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Spine Surgery ◽

Invasive Surgery ◽

Spinal Deformity ◽

Interbody Fusion ◽

Adult Spinal Deformity ◽

Minimally Invasive Spine Surgery ◽

Complication Rates ◽

Minimally Invasive Spine

<p>To provide a comprehensive summary of the status, indications and developments in the use of minimally invasive surgery in the field of adult spinal deformity. This study was performed by expert review of literature which has been published and is indexed on PubMed. The most appropriate and recent articles were selected to obtain a consolidation of information and knowledge on use and benefits of minimally invasive surgery in adult spinal deformity. Various MIS techniques have been developed to perform the complex ASD surgeries. These include the transforaminal lateral interbody fusion (TLIF), percutaneous segmental fixation as well as the lateral body interbody fusion (LLIF). It is important for a surgeon to obtain a holistic view of current literature and recommended guidelines on the procedures available for ASD surgeries. Overall, minimally invasive spine surgery has resulted in less use of pain medicine, less blood loss, lower infection rates, less requirement for intensive care, less hospitalization, reduction in physiologic stress, reduction in complication rates, reduction in muscle atrophy and preservation of normal motion with fusion rates being as high as 80-95%. More articles consolidating the vast literature on minimally invasive spine surgery need to be published to allow a surgeon to effectively weight the benefits and drawbacks of it. More research needs to be performed to compare the efficacy of sub-types of minimally invasive spine surgery.</p>

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Colonic stenting in acute malignant large bowel obstruction - an audit of efficacy and safety in a tertiary referral centre in Singapore

Singapore Medical Journal ◽

10.11622/smedj.2021127 ◽

2021 ◽

Author(s):

JW Li ◽

JCY Ngu ◽

KR Lim ◽

SW Tay ◽

B Jiang ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Large Bowel ◽

Clinical Success ◽

Primary Anastomosis ◽

Large Bowel Obstruction ◽

Referral Centre ◽

Tertiary Referral ◽

Tertiary Referral Centre

Introduction: Acute malignant large bowel obstruction (MBO) occurs in 8-15% of colorectal cancer patients. Self-expandable metal stents (SEMS) have progressed from a palliative modality to use as bridge-to-surgery (BTS). We aimed to conduct a clinical audit on safety and efficacy of SEMS for MBO in our institution. Methods: Data from a prospectively maintained electronic database in a tertiary referral centre in Singapore was reviewed for all consecutive patients undergoing SEMS insertion for MBO. Technical success defined as successful SEMS deployment across tumour without complications. Clinical success defined as colonic decompression without requiring further surgical intervention. Rates of complications, median time to surgery, types of surgery and rates of recurrence were studied. Results: 79 patients underwent emergent SEMS placement from September 2013 to February 2020. Mean age 68.8±13.8 years, male 43/79 (54%). Mean tumour length 4.2cm±2.2cm; 89.9% (71/79) distal to splenic flexure. Technical and clinical success was 94.9% (75/79) and 98.7% (74/75), respectively. Perforation occurred in 5.1% (4/79), with no cases of stent migration or bleeding. 50/79(63.3%) of SEMS inserted as BTS. Median time to surgery was 20 days (range 6-57). Majority (41/50;82%) underwent minimally invasive surgery (robotic-assisted 7/50,14%; laparoscopic 34/50,68%). Primary anastomosis rate was 98% (49/50). 39 patients had follow-up beyond 1-year post-treatment (median 34 months). Local recurrence and distant metastasis were observed in 4/39(10.3%) and 5/39(12.8%), respectively. Conclusion: SEMS acute MBO has high technical and clinical success rates with a good safety profile. Majority of patients in our audit underwent minimally invasive surgery and primary anastomosis after successful BTS.

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