Minimally invasive spine surgery has developed out of the desire to effectively treat disorders of the spinal discs with minimal muscle related injury, and with rapid recovery.
Traditionally, surgical approaches to the spine have necessitated prolonged recovery time. For example, in the 1990s the state-of-the-art procedure for fusion of the lumbosacral spine has been the instrumented posterolateral fusion. In order to perform this procedure, a large incision is made and the back muscles are moved away from their spinal attachments, allowing the surgeon space to place rods, screws, and bone graft.
First, this surgical approach (i.e., dissecting the muscles) produces the majority of the surgical pain and delays return to full activity. The degree of the surgical pain necessitates the use of significant pain medication with their inherent side effects. Also, the degree of the surgical pain delays return to normal daily activities and nonphysical work.
Second, the separation of the muscles from their normal anatomic points of attachment results in a healing by scarring of these muscles. The various layers of the individual muscle scar to one another losing their independent function. And, it has been found that this type of separation results in the loss of innervation (i.e., the supply of nerve stimulation) of the muscles with subsequent wasting away. Resulting in a permanent weakness of the back muscles This weakness itself may be symptomatic (as a back fatigue-type pain) and/or limit the patient’s function – particularly in those who perform physical work. These side effects of the posterior approach to the lumbar spine have been called fusion disease.