Overview of Minimally Invasive Spine Surgery with the Tubular Retractor

Abstract

Spine surgeons have been trying to abstain from all intentional wrong-doing and harm while they treat various spinal diseases. However, conventional open spine surgery would inherently disrupt the posterior paraspinal muscles and lead to long-term muscle atrophy and chronic back pain. Consequently, minimally invasive spine surgery (MISS) has been developed to avoid them in the last decades, with the progress of tubular retractors, endoscopes, and microscopes. With the integration of the microscope and tubular system, the MISS with tubular retractor gained popularity with minimally invasive spine surgeons, and numerous reports emerged for lumbar microdiscectomy, lumbar decompression, transforaminal lumbar interbody fusion, thoracic decompression, cervical foraminotomy, and cervical decompression. Although a learning curve problem might exist, the MISS with the tubular retractor would be performed more accurately, safely, and popularly. The paramedian approach and mechanical features of the tubular retractor would attribute to maintaining the posterior paraspinal muscle integrity and may lead to more favorable long-term clinical outcomes and cost-effectiveness compared to conventional open surgery.