With advances in surgical techniques in recent years, orthopaedic surgery has tended to become minimally invasive, with access techniques, endoscopic techniques, and closure techniques common in spinal surgery. In addition, as surgeons’ technical proficiency has advanced and patient demand has increased, the indications for minimally invasive surgery have been relaxed compared to previous years. As a result, there has been a significant increase in the volume of minimally invasive procedures and the variety of surgical approaches. However, there are strict indications for any surgical procedure, especially for minimally invasive surgery, which places high demands on both surgeon and patient and should be strictly controlled.
Lumbar spondylolisthesis is often associated with isthmic fissures, has a long history of disease, has severe intervertebral scar adhesions and is often associated with abnormal nerve root position, making decompression and internal fixation under foraminoscopy or access more difficult and significantly increasing the chance of nerve root injury, so minimally invasive surgery is not recommended.
Lumbar disc prolapse is a condition where the nucleus pulposus breaks out of the fibrous ring and falls into the spinal canal. Due to the action of chemicals in the nucleus pulposus, it often adheres to the dura and is even encapsulated by the dura. Although many “masters” of foraminoscopic techniques have reported successful cases, we recommend that minimally invasive surgery be chosen with caution.
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