Approaches and Relative Benefits of Open Versus Minimally Invasive Surgery for Degenerative Conditions

Minimally invasive techniques aim to improve upon traditional open surgeries by limiting the morbidity of the surgical approach. In doing so, soft tissue collateral injury is minimized, the midline is relatively spared, and the amount of osseous resection is reduced. Both open and minimal-access procedures are options for decompressing neural tissue, correcting spinal column malalignment, or stabilizing vertebral motion segments. Minimally invasive techniques reduce the necessary soft tissue retraction and surgical dissection with the goal of reducing postoperative pain and expediting recovery. However, the limited access afforded by these approaches can be challenging for complex and revision procedures, and the surgeon must be familiar with the specialized instrumentation and novel technologies. The decision to use minimally invasive techniques is multifactorial and is largely dependent on patient, surgeon, and hospital factors.