Current status of minimally invasive thoracolumbar spine surgery for treating neoplastic, traumatic, and infectious spine diseases

The application of minimally invasive spine surgery (MIS) for treating thoracolumbar spine disorders and injuries has evolved rapidly, and the technical feasibility and safety of MIS has been well established. The successful use of MIS for treating degenerative spine diseases has broadened its scope, and this technique is now used for treating nondegenerative diseases. For spinal neoplastic diseases, MIS is suitable for patients with intradural extramedullary tumors limited to one or two spinal segments. However, the feasibility of MIS in treating intramedullary or complicated large intradural extramedullary tumors remains unclear. For traumatic spine diseases, the outcomes of percutaneous pedicle screw instrumentation are comparable with those of open pedicle screw instrumentation for treating thoracolumbar compression fractures without neurological deficits. However, the efficacy and safety of MIS for patients with advanced-type thoracolumbar fractures or neurological deficits remain debatable. Percutaneous endoscopic lavage and drainage facilitates prompt and sensitive antibiotic therapy against the offending pathogens in infectious spine diseases and is particularly suitable for patients with early-stage spinal infections or serious medical conditions. With the advances in MIS techniques and the improved knowledge regarding diseases and the anatomy of the spine, MIS can be used for treating various spine diseases.