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By Richard G Fessler MD PhD

This factor of Neurosurgery Clinics of North the United States is dedicated to "Minimally Invasive backbone Surgery" and is edited via Zachary A. Smith, MD and Richard G. Fessler, MD, PhD. Articles during this factor contain: problems and hardship avoidance of minimally invasive backbone surgical procedure; Radiation publicity danger and avoidance; present innovations within the administration of cervical myelopathy and radiculopathy; Thoracic disc/pathology administration via minimally invasive routes; Transforaminal Lumbar Interbody fusion: long-term results and issues; Computer-assisted navigation process for minimally invasive transforaminal lumbar interbody fusion and lateral interbody fusion; safeguard and the Anatomy of the retroperitoneal lateral hall; Minimally invasive extracavitary transpedicular corpectomy for the administration of spinal tumors; Minimally invasive anterolateral corpectomy for spinal tumors; Minimally invasive techniques for the administration of intramedullary spinal tumors; Percutaneous fixation of thoracolumbar fractures; Advances and feasibility of complex minimally invasive concepts in deformity correction; Direct lateral process: results and Deformity Correction; and proof foundation and results.

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3). 3. G. Blackman, Center for Minimally Invasive Scoliosis Surgery, Oakland, CA). LUMBAR SPINE Laparoscopic Fusion and Bagby and Kuslich Cages Laparoscopy has been used successfully in general surgery as a minimally invasive alternative to a huge array of patients who previously underwent an open laparotomy. The chief advantages of a laparoscopic procedure are the significantly reduced postoperative pain, early return to work, and shorter hospital stay. Lumbar arthrodesis continues to be a controversial subject, with some proponents supporting anterior fusion, others supporting posterior fixation using a pedicle screw fixation system, and others supporting both anterior and posterior constructs.

J Neurosurg 84:104–109, 1996. 7. Dickman CA, Rosenthal D, Karahalios DG, Paramore CG, Mican CA, Apostolides PJ, Lorenz R, Sonntag VKH: Thoracic vertebrectomy and reconstruction using a microsurgical thoracoscopic approach. Neurosurgery 38:279–293, 1996. 8. Dieter RA Jr, Kuzycz GB: Complications and contraindications of thoracoscopy. Int Surg 82:232–239, 1997. 9. Guingrich JA, McDermott JC: Ureteral injury during laparoscopy-assisted anterior lumbar fusion. Spine 25:1586–1588, 2000. 10. Harkki-Siren P, Sjoberg J, Kurki T: Major complications of laparoscopy: A follow-up Finnish study.

Injury to the intercostal nerve, artery, or vein is also possible during trocar placement. Damage to the nerve can result in severe postoperative pain and dysesthesia. Injury to large intrathoracic vessels can occasionally occur from inadvertent placement of instrumentation. It is imperative that all ports, after the initial endoscopic port, be placed under continuous endoscopic vision and that all instruments be visualized from entry to exit from the chest cavity. Bleeding from port sites can be more a nuisance than a complication and can be controlled with bipolar coagulation.

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