How Patients Choose Minimally Invasive Treatment for the Lumbar Spine Erxing He Erxing, Department of Spine Surgery, The First Hospital of Guangzhou Medical University Minimally invasive surgery is a familiar name. Minimally invasive techniques —-, as the name implies, means that the surgical trauma is smaller than conventional open surgery, and the trauma is not only small in terms of skin incisions, but the overall trauma should also reach a tiny level. Therefore, the original physiological function and anatomical structure of the patient undergoing minimally invasive surgery can usually be largely preserved as “original”, and the post-operative recovery is fast, which is very popular among patients and also a requirement for doctors! Why can many lumbar spine pathologies be treated with minimally invasive surgery? It turns out that, in general, the direct cause of pain and weakness in the lower extremities is the compression of a nerve in a very small area. Therefore, by releasing this limited compression, the goal can be achieved. Due to the limitations of technique, experience, and equipment, in the past, the surgeon could only make a large opening in the patient to deal with the lesion deep in the lumbar spine, and the opening also destroyed the normal structures such as muscles and spinal canal. The disadvantages of open surgery are well known to all surgeons, so doctors have been working hard to improve the technique and bring the damage of surgery to the lowest level. Suffice it to say, the less damage this surgery can do, the better the surgeon’s skill level, provided the problem can be solved! Patients should always ask their doctors: Can the problem be solved? Which procedure will cause the least damage? Doctors often recommend the following minimally invasive treatment modalities to patients: discectomy The current techniques commonly used for minimally invasive lumbar discectomy include puncture lysis, radiofrequency ablation, discoscopy or foraminoscopic resection. The surgery is aimed at removing the herniated disc tissue with minimal trauma, but has a high recurrence rate and is suitable for patients with early disc herniation and less severe rupture. Spinal decompression spinal stenosis is also a common cause of back and leg pain. Moreover, herniated discs and spinal stenosis often coexist. Spinal stenosis requires the removal of bone from the spinal canal to loosen nerve compression. Spinal decompression can be performed at the same time as a discectomy. A common minimally invasive spinal canal decompression is a discoscopic osteotomy. Decompression under expandable access is about as invasive as open surgery, but some surgeons still refer to it as minimally invasive surgery. Lumbar fusion fusion means fixing the adjacent vertebrae and allowing them to eventually grow together. This treatment is needed in patients with severe disc injuries, or in patients who require more bone to be amputated during decompression of the spinal canal, or who have pre-existing spinal instability. Lumbar fusion requires removal of the disc and amputation of some of the bone in the spinal canal, which is slightly more damaging, but is the only curative treatment available. Minimally invasive lumbar fusion is a microscopic or minimally incised intervertebral fusion coupled with lumbar screw fixation, which is complex and currently performed in only a few hospitals. Doctors will often only refer to the technique they recommend as the best option. Patients should be knowledgeable about this to make the right judgment! This article is published with permission from Dr. Erxing He.