A review of minimally invasive techniques for correction of adult spine deformity

Abstract

This paper highlights the current status of minimally invasive surgery (MIS), with special attention to learning curve, cost-effectiveness, and different techniques, for the correction of adult spine deformity (ASD). A literature review was performed through the PubMed database. Studies that fit the inclusion criteria (n = 27) were analyzed by the authors through the MINORS criteria and their results were then presented. The abundance of data on the learning curve of the procedure shows that it takes at least 22–39 surgeries for a surgeon to reach optimal operative time. The literature search showed that there is a paucity of data available on the cost-effectiveness of the procedure in developing countries; however, if the results from the developed countries were to be considered, MIS is cost-effective for ASD correction. There are certain limitations to the procedure including inadequate sagittal balance as well as chances of proximal junctional kyphosis and adjacent segment disease; however, the overall benefits of MIS including decreased operative time, blood loss, and hospital stay could tilt the balance in its favor.