The ultimate resource for learning and mastering minimally invasive spine surgery techniques
An estimated 1.5 million instrumented spinal procedures are performed
every year in the US. The majority of decompressions and about 50% of
fusion procedures can be performed completely or partially using
minimally invasive spine surgery (MISS) techniques. The full potential
of MISS techniques has yet to be realized. Essential Step-by-Step Techniques for Minimally Invasive Spinal Surgery
by internationally renowned MISS neurosurgeon Roger Härtl,
spine-neurosurgeon Rodrigo Navarro-Ramirez, and an impressive group of
global multidisciplinary contributors is the most comprehensive and
detailed textbook written to date on this topic.
The foundation of the book is built on six interacting principles
critical to surgical success, and MISS in particular: Target,
Technology, Technique, Teaching and Training, Testing, and Talent. The
text starts with an opening chapter on the definition of MISS and
introduction of these principles. Fifty-six subsequent chapters provide a
comprehensive discussion on how to utilize an MISS approach for a full
spectrum of spinal pathologies using nuanced variations specific to the
operating surgeon. To ensure readers are well versed in all aspects of
MISS, these chapters include painstaking details on indications,
contraindications, pathoanatomy, operating room set-up, step-by-step
techniques, and postoperative management.
Contributions from master spine surgeons across the world provide a
balanced global perspective on mastering and incorporating diverse
techniques into practice
Invaluable clinical pearls including tips/tricks and complication avoidance
High-quality images, figures, anatomic drawings, and imaging studies
illustrate relevant anatomic approaches and corridors and delineate why
anatomic mastery is critical to MISS
Twenty-five videos enhance the ability to learn and implement MISS approaches
This is a must-have resource for practicing spine surgeons interested
in MISS who wish to learn the latest techniques from master surgeons
and achieve optimal patient outcomes. The text and videos also provide a
robust training tool for senior-level orthopaedic and neurosurgery
residents and spine fellows.
Table of Contents
Part I Introduction to MISS 1. Definition of MISS: The "6 Ts": Target/Technology/Technique/Teaching and Training/Testing/Talent 2. Global MISS: Perspectives from Asia, Australia, Europe, Middle East, North America, and South America Part II MISS Target 3.
Target Philosophy in Degenerative Spinal Disorders: Correlation of
Clinical Presentation, Physical Examination, and Response to
Interventional Procedures 4. Deformity and MIS: Limitation or Opportunity? 5. Target: The Muscle as a Pain Generator and Key Element to Protect During MIS Surgery Part III MISS Technology 6. Tubular and Specular Retractors in MISS 7. Navigation in MISS 8. Robotics: Background and Current Role 9. Microscope in MISS 10. Endoscope in MISS: How to Adopt and Change Part IV MISS Techniques 11. Three Surgical Principles of MISS: Contralateral Decompression, Minimize Instability, and Indirect Decompression 12. Surgical Techniques and Instrumentation in MISS 13. Dural Repair in MISS and CSF Leak Management 14. How to Achieve a Successful Fusion with MIS Techniques 15.
Surgical Tips, Tricks, and Techniques to Minimize Invasiveness; General
Advice on How to Handle Fluoroscopy, Blood Loss, and Infection Rates 16. Perioperative Management; ERAS 17. Key Elements to Safely Transition from Inpatient to Outpatient Spine Surgery 18. Posterior Cervical Foraminotomy/Discectomy 19. Unilateral Tubular Over-the-Top Cervical Laminectomy for Cervical Stenosis 20. Posterior Cervical Facet Cages DTRAX 21. MIS Endoscopic Approaches For OC–C1–C2 Pathology 22. Posterior Muscle Sparing Approaches for Decompression, Laminoplasty, and Laminectomy 23. Minimally Invasive C1/C2 Fusion 24. Cervical Three-Dimensional Navigation to Facilitate Minimally Invasive Spine Surgery 25. Thoracic Vertebroplasty and Kyphoplasty 26. Thoracic Discectomy: Posterior Transpedicular Tubular Approach 27. Lateral Retropleural Thoracic Discectomy and Corpectomy 28. Mini-Open Pedicle Subtraction Osteotomy for Deformity Correction 29. Posterior Paramedian Endoscopic Thoracic Discectomy 30. Transpedicular Corpectomy and Fusion for Metastatic Tumor or Infection 31. Techniques to Decrease the Invasiveness of Thoracic Deformity Correction 32. Unilateral Lumbar Approach For Over-the-Top Bilateral Decompression 33. Far-Lateral Lumbar Discectomies 34. Percutaneous Full-Endoscopic Interlaminar Approach for Lumbar Pathologies: Disc Herniation and Lumbar Spinal Stenosis 35. Transforaminal Approach for Endoscopic Decompression 36. Endoscopic Interlaminar Lumbar Laminectomy 37. LLIF T12/L1-L2 38. LLIF L2/3/4/5 39. Translumbar Surgery Comparison: Four Surgeons and Regions 40. Minimally Invasive Oblique Anterior Lumbar Interbody Fusion 41. Maximum Access Surgery Posterior Lumbar Interbody Fusion 42. MIS-TLIF with Total Navigation and Expandable Interbody Cages 43. MIS-TLIF Comparison: Four Surgeons and Regions 44. Percutaneous Pedicle Screw Fixation and MISS SI Joint Fusion 45. Intradural Extramedullary Tumors 46. Three-Dimensional Navigation in Lumbar Spine to Facilitate Minimally Invasive Spine Surgery 47. Strategies to Minimize Invasiveness and Optimize Success: OC Fusion 48. Strategies to Minimize Invasiveness and Optimize Success: Cervical Front/Back Surgery for Deformity Correction 49. MIS Cervical Pedicle Screws—Percutaneous-Assisted Technique 50. Treatment of Degenerative Lumbar Scoliosis with Minimally Invasive Multilevel LLIF in Combination with Lateral ALIF 51. Strategies to Minimize Invasiveness and Optimize Success: T10-Pelvis 52. Lifestyle Medicine: Optimizing Recovery Following MIS of the Spine 53. Three-Dimensional Navigation in MISS Part V Teaching and Training/Future 54. Surgical Training and Simulation in MISS 55. The Role of Biologics in Minimally Invasive Spine Surgery 56. Summary and Outlook—Future of Lumbar Minimally Invasive Surgery 57. Achieving MISS on a Global Level