Postchemonucleolysis discectomy versus repeat discectomy: a prospective 1- to 13-year comparison

The technological development of minimally invasive spine surgery

Minimally invasive spine surgery has its roots in the mid-twentieth century with a few surgeons and a few techniques, but it has now developed into a large field of progressive spinal surgery. A wide range of techniques are now called "minimally invasive," and case reports are submitted constantly with new "minimally invasive" approaches to spinal pathology. As minimally invasive spine surgery has become more mainstream over the past ten years, in this paper we discuss its history and development.

Surgery: indications and options

The challenge is to better define the present role of spine surgery and more completely understand its realistic benefits and consequences. In spite of modern sophistication, spine surgery can still accomplish only the same two broad objectives, decompression and fusion, that have been possible for more than a century. Never vague or tentative, surgery has its place in the narrow spectrum of cases with clearly established, well circumscribed, structural pathology unresponsive to nonsurgical treatment and producing significant persistent disability. Identifying valid indications and options within the plethora of choices requires knowledge of what is available, what can actually be accomplished, and what limitations apply.