Minimally Invasive Spine Surgery for Degenerative Lumbar Diseases: Current Advances and Future Perspectives
TL;DR
This narrative review was conducted to systematically characterize the state-of-the-art application of MISS for DLD management and outline promising developmental directions for minimally invasive lumbar interventions.
Abstract
Degenerative lumbar diseases (DLDs), encompassing lumbar disc herniation, lumbar spinal stenosis, degenerative spondylolisthesis and degenerative lumbar scoliosis, constitute a predominant global source of chronic low back pain and radiculopathy. Such conditions markedly degrade patients’ quality of life and place a heavy socioeconomic burden on healthcare systems. Conventional open posterior lumbar surgery delivers satisfactory spinal decompression and interbody fusion, yet it is plagued by prominent drawbacks: severe paraspinal muscle injury, substantial intraoperative blood loss, intractable postoperative pain, longer hospital stays, and an increased risk of adjacent segment disease. Fueled by advances in surgical navigation, spinal endoscopy and intraoperative neuromonitoring, minimally invasive spine surgery (MISS) has achieved remarkable progress. These minimally invasive procedures retain the integrity of the posterior ligamentous complex, drastically lessen soft tissue trauma, and enable accelerated early postoperative rehabilitation. This narrative review was conducted to systematically characterize the state-of-the-art application of MISS for DLD management. High-quality peer-reviewed studies were retrieved and synthesized to summarize mainstream MISS techniques, operative workflows, perioperative clinical outcomes, surgical complications and inherent technical limitations. We further outline promising developmental directions for minimally invasive lumbar interventions. This work aims to furnish evidence-based references for clinical therapeutic decision-making and facilitate future translational research related to DLD minimally invasive treatment.