ABSTRACT
An appropriate patient selection for minimally invasive (MIS) revision surgery is critical to achieving good clinical outcomes. A thorough physical examination is mandatory and plays an important role in assessing symptoms caused by recurrent disc herniation or lumbar stenosis symptoms. Biplanar lumbar spine radiographs provide valuable information about lumbar spine alignment and local deformity. The rationale and final goal for the MIS revision decompression surgery is similar to that of the primary surgery, which is decompression of the neural structures without extensive bone and muscle disruption. The monitoring of neural function may help guide decompression in cases of severe neural compression, or even conus/cauda compression, which is often regarded as a contraindication to MIS. An ipsilateral decompression is utilized when symptomatic recurrent compression is confined to only one side of the spinal canal. In patients whose symptoms can be related to lateral recess stenosis, the medial portion of the superior articular process is drilled and resected.
