ABSTRACT
This chapter discusses the existing evidence comparing the results of a variety of minimally invasive techniques to their open counterparts. Minimally invasive approaches to surgical procedures have gained popularity. The proposed benefits of these approaches include diminished surgical trauma, scarring, preservation of anatomy, earlier patient recovery, improved cosmesis, and potentially better clinical outcomes. The morbidity of an open thoracotomy is substantial. Rates of intercostal neuralgia and postoperative incisional pain are high. In addition to being less frequent than cervical or lumbar disc herniations, the morbidity of open anterior thoracic surgery can be prohibitive of thoracic discectomy except for the most serious conditions, such as myelopathy from spinal cord compression. Minimally invasive techniques have a long history in the treatment of lumbar disc pathology. Although they have lost much of their initial popularity, a substantial body of randomized, controlled data concerning chemonucleolysis, percutaneous lumbar discectomy, and percutaneous laser discectomy exists.
