Interbody fusion of the lumbar spine under mini-invasive technique (with videoscopic control)

The development of mini-invasive surgical techniques startedtwenty years ago. After the first cholecystectomy by celioscopy, anumber of videoscopic surgical techniques were rapidly developed.Spinal surgery followed this evolution. Its aim is to perform thesame operative procedure with a less invasive surgical approach,according to the principles of celioscopic surgery. Minimalizationof the parietal damages allows a reduction of surgery time, of bleedingand transfusion rate, of postoperative pain and of the duration ofhospital stay and recovery time. These mini-invasive techniquesallow bone grafting and osteosyntheses with plates and/or cages.The first published series confirm to a large degree the initial hopesplaced in these new techniques. Nevertheless, these techniques imposea specific surgical education of the surgeon and a long learningcurve. Despite the good results and the low morbidity, thesessurgical approaches do not change the operative indications of spinalarthrodesis and we have to keep in mind the rate of success ofnon-invasive medical treatments.