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T
he ability to do minimally invasive spinal fusion comes down to 3
primary considerations: patient preparation, pain control and the
ability to minimize collateral damage around the spine. Once you
reach the targeted vertebrae, the operation is essentially the
same as it would be in an open procedure. What's different with
outpatient cases is how you go about getting there.
The spine is deep in the body and surrounded by a lot of muscles. To get to it,
you have to expose it, which in itself is no small feat. Then comes the hardware
— screws, rods and cages. Until fairly recently, the combination required a large
incision, lots of muscle damage, plenty of strong pain meds and a lengthy hospi-
tal stay.
So one of the first big challenges is figuring out how to reach the spine with-
out causing too much injury to the surrounding muscles. "We can now do fusion
through minimally invasive access and small incisions," says John Liu, MD, co-
director of the USC Spine Center in Los Angeles, Calif. "There are several surgi-
• FUSED APPROACH Dr. Villavicencio, shown here performing a minimally invasive transforaminal lumbar interbody fusion, says patient
selection is key.
Neurosurgical
and
Spine
Associates
Is It Time to
Add Spinal Fusion?
Minimally invasive techniques have transformed a complex open
surgery into a viable outpatient option.
Jim Burger | Senior Editor
