Minimally Invasive Spine Surgery: Surgical Techniques and by Frank Phillips, Isador Lieberman, David Polly

By Frank Phillips, Isador Lieberman, David Polly

Over the previous decade, minimally invasive ideas have constructed speedily and are commonly utilized within the administration of backbone problems. With the improvement of permitting applied sciences, together with in particular designed spinal retractor structures, intraoperative imaging and navigation applied sciences, and real-time neural tracking, minimally invasive backbone surgical procedure (MISS) suggestions are secure, potent and reproducible. certainly, reports have proven the scientific and fiscal benefits of those tactics.

Minimally Invasive backbone Surgery comprises distinctive discussions of permitting applied sciences, surgical suggestions (including posterior decompression and fusion), techniques to precise ailments and prerequisites, in addition to techniques to regulate the original dangers and problems of leave out. Generously illustrated, this may be an important reference for orthopedic surgeons, neurosurgeons and all well-being care pros who deal with the spine.

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In contrast to the multifidus muscle, micro-architectural studies reveal that these muscles are designed with long muscle fascicles with relatively small PCSA. This anatomic morphology suggests that they serve to move the trunk to extension, lateral bending, and rotation. With this type of design, they are less likely to act as primary stabilizers of the vertebral column [29]. The Interspinales, Intertransversarii, and Short Rotator Muscles The interspinales, intertransversarii, and short rotator muscles are short flat muscles that lie dorsal to the intertransverse ligament (Fig.

In other words, one must determine the incremental cost of the demonstrated short-term perioperative benefits of MIS fusions.  conomic Comparison of MIS Versus E Open Fusion In an excellent review of this topic, Allen and Garfin note the increasing importance of CEA in our current health-care environment. However, the authors point out the general lack of HEEs in the currently available literature [18, 32]. In addition, the authors importantly note that a “consistent method of exactly which cost to include, and how to accurately measure direct and indirect cost is yet to be defined in spine care, and existing cost analyses of spine care vary widely in their methods of measurement” [32].

Kim and Choll W. Kim Philosophy of Minimally Invasive Surgery (MIS) The goals of minimally invasive spine surgery are to accomplish the same goals of traditional open spine surgery whether it is decompression, fusion, or correction of deformity. The key concepts that guide MIS approaches are as follows: (1) decrease muscle crush injuries during retraction; (2) avoid detachment of tendons to the posterior bony elements, especially the multifidus attachments to the spinous process and superior articular processes; (3) maintain the integrity of the dorsolumbar fascia; (4) limit bony resection; (5) utilize known neurovascular planes; and (6) decrease the size of the surgical corridor to coincide with the area of the surgical target site.

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