Physicians discussed the practical challenges of adopting minimally invasive spine surgery procedures during the session titled "The Current State of Minimally Invasive Spine Surgery" at the American Academy of Orthopaedic Surgeons Annual Meeting 2013 in Chicago.
Presenters Mark Dekutoski, MD, Eugene Koh, MD, and Gregory Mundis, MD, weighed in on various uses of MIS surgery in the panel, which was moderated by Alexander Ching, MD. While no one definition exists for minimally invasive, the presenters agreed upon the basic premise of providing the same fixation, stabilization or decompression as open procedures while better preserving soft tissue.
Physicians should be vigilant to use MIS approaches only in cases that could greatly benefit. It should not be a way to convince more patients to get spine surgery. "Minimally invasive spine surgery is a means to an end, an approach or technique to achieve the goal," Dr. Mundis said. "It should not be used as a marketing ploy."
Planning ahead is crucial for less invasive procedures, Dr. Koh said. When using minimally invasive techniques for deformity patients, he recommended five steps to approaching an MIS surgery:
1. Measure all key parameters
2. Quantify the deformity
3. Evaluate all clinical options
4. Execute your plan
To get an introduction to MIS, physicians can take device company-sponsored cadaver lab courses or North American Spine Society skin-to-skin courses for more hands-on experience in controlled settings. When incorporating those new techniques in the operating room, physicians should "start with fixations that are most familiar to you," Dr. Ching said, and build to more difficult fixations.
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Physicians should be vigilant to use MIS approaches only in cases that could greatly benefit. It should not be a way to convince more patients to get spine surgery. "Minimally invasive spine surgery is a means to an end, an approach or technique to achieve the goal," Dr. Mundis said. "It should not be used as a marketing ploy."
Planning ahead is crucial for less invasive procedures, Dr. Koh said. When using minimally invasive techniques for deformity patients, he recommended five steps to approaching an MIS surgery:
1. Measure all key parameters
2. Quantify the deformity
3. Evaluate all clinical options
4. Execute your plan
To get an introduction to MIS, physicians can take device company-sponsored cadaver lab courses or North American Spine Society skin-to-skin courses for more hands-on experience in controlled settings. When incorporating those new techniques in the operating room, physicians should "start with fixations that are most familiar to you," Dr. Ching said, and build to more difficult fixations.
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