• Chibuikem A Ikwuegbuenyi, Sean Inzerillo, Evan Wang, and Ibrahim Hussain.
• Department of Neurological Surgery, New York Presbyterian Hospital/Och Spine, Weill Cornell Medicine, New York, New York, USA.
• Neurosurgery. 2025 Mar 1; 96 (3S): S139S147S139-S147.

AbstractMinimally invasive spine surgery (MISS) has transformed spinal surgery by minimizing tissue disruption, reducing recovery times, and lowering complication rates compared with traditional open procedures. MISS uses smaller incisions, specialized tools, and advanced imaging to treat conditions such as degenerative disk disease, trauma, and tumors. Techniques such as endoscopic spine surgery and tubular retractors have expanded its applications, enabling effective treatment with less postoperative pain and faster mobilization. Patient selection is crucial to the success of MISS, requiring detailed imaging analysis and consideration of overall health and pathology. Although MISS provides significant benefits, it is less effective for complex spinal deformities that require extensive sagittal or coronal corrections. Technological advancements, including robotic assistance and augmented reality, are enhancing surgical precision and expanding the scope of MISS. Enhanced recovery after surgery protocols, when combined with MISS, improve outcomes by reducing hospital stays and postoperative pain. Complications such as dural tears and hardware misplacement, although less common than in open surgery, require careful management, with techniques such as intraoperative imaging and robotic navigation aiding in complication prevention. Continued innovation in MISS will broaden its application and improve safety and patient outcomes across various spinal pathologies.Copyright © Congress of Neurological Surgeons 2025. All rights reserved.

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