ABSTRACT
This chapter discusses the concept and history of minimally invasive spine surgery (MISS). Percutaneous transforaminal and epidural injections are commonly used for diagnostic and therapeutic purposes. A needle is docked at a desired location and anesthetic, with or without steroid medication is delivered. This is generally performed with fluoroscopic guidance. Laparoscopic lumbar spine surgery was introduced by Obenchain in the early 1990s for anterior discectomy and interbody fusions. However, identified risks, including sexual dysfunction and visceral and vascular injuries, were encountered more frequently than with open procedures and were more technically challenging to repair. The greatest limitations of MISS are the technical and instrument demands. Surgical goals are the same; however, some of the techniques have grown greatly in complexity, albeit with varying returns. Consequently, there has been an emphasis to return partially toward traditional open surgical techniques but with less soft-tissue and bony destruction.
