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Minimally Invasive Spine Surgery: Evidence, Advances and Controversies

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 1004

Special Issue Editors


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Guest Editor
Spine Surgery Service, Swansea Bay University Health Board, Swansea, UK
Interests: spine surgery; minimally invasive spine surgery; endoscopic spine surgery; degenerative spine disorders; spine oncology; spine trauma

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Guest Editor
Division of Neurosurgery, University Hospital of Patras, University of Patras, Patras, Greece
Interests: spine surgery; minimally invasive spine surgery; endoscopic spine surgery; chronic pain surgery

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Guest Editor
Division of Neurosurgery, QEII Health Sciences Center, Dalhousie University, Halifax, NS, Canada
Interests: neurosurgery; spine surgery; spine oncology; neurotrauma

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Guest Editor
1. Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
2. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
Interests: neurosurgery; spine surgery; minimally invasive spine surgery; epidemiology

Special Issue Information

Dear Colleagues,

The progress of minimally invasive spine surgery (MISS), with the wide range of techniques now applied worldwide, has transformed the field of spine surgery over the decades. Since its introduction in the late 20th century, MISS has evolved from tubular decompressions to endoscopic and robotic-assisted spinal procedures, while the therapeutic indications of MISS have expanded widely.

Most spine surgery units now offer minimally invasive techniques due to their well-documented advantages, including reduced blood loss, less postoperative pain, faster mobilisation, and shorter hospital stay. Despite the widespread adoption of MISS and the availability of several established and popular techniques, many important questions and controversies remain to be addressed. For example, key areas of ongoing debate include the learning curve and long-term clinical outcomes compared with conventional open surgery. Moreover, recent developments such as endoscopic lumbar interbody fusion, robotic-assisted navigation, augmented reality, and artificial intelligence-based planning are expected to further expand the possibilities of MISS.

In this Special Issue, we invite authors to submit original research and comprehensive review articles on advances and controversies in MISS, aiming to provide new insights to the scientific community and to propose directions for future research.

Dr. Miltiadis Georgiopoulos
Prof. Dr. Constantine Constantoyannis
Dr. Mark A. MacLean
Dr. Oliver Lasry
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • spine surgery
  • minimally invasive
  • MIS
  • MISS
  • endoscopic
  • tubular
  • fusion
  • laminectomy
  • discectomy
  • decompression
  • percutaneous
  • robotic
  • robotic-assisted
  • navigation
  • augmented-reality

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Published Papers (1 paper)

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20 pages, 1296 KB  
Systematic Review
The Limited Evidence Base for Multilevel Lumbar Interbody Fusion and Its Consequences for Clinical Conclusions: A Systematic Review
by Evan R. Simpson, Casey Slattery, Kalyn Smith, Jesse Caballero, Michael Gordon, Gerald Alexander, Jon White, Jeffrey Deckey, Jeremy Smith and Vance Gardner
J. Clin. Med. 2026, 15(6), 2289; https://doi.org/10.3390/jcm15062289 - 17 Mar 2026
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Abstract
Background/Objectives: Lumbar interbody fusion (LIF) is widely utilized to treat multilevel degenerative lumbar spine pathologies. This systematic review aimed to comprehensively review lateral and posterior multilevel LIF procedures and their clinical and radiographic outcomes. Methods: Following the PRISMA guidelines, a search [...] Read more.
Background/Objectives: Lumbar interbody fusion (LIF) is widely utilized to treat multilevel degenerative lumbar spine pathologies. This systematic review aimed to comprehensively review lateral and posterior multilevel LIF procedures and their clinical and radiographic outcomes. Methods: Following the PRISMA guidelines, a search of PubMed, Embase, Web of Science, and Cochrane identified eligible studies. Patient demographics, as well as clinical and radiographic outcomes were collected. Risk of bias was assessed using the MINORS criteria, while randomized trials were evaluated using the RoB-2 tool. An extensive subgroup analysis was completed when that was possible. Results: A total of 45 studies were included consisting of 5623 patients. The pooled outcomes indicated that TLIF demonstrated the lowest operative duration (198.7 ± 77.83 min) and LOS (5.09 ± 2.5 days), alongside favorable ODI (33.68 ± 6.43), VAS leg pain (5.39 ± 0.66), and VAS back pain (4.67 ± 0.79) score gains. Comparative evidence found that LLIF and OLIF provided advantageous radiographic improvement to the posterior approaches. Comparative evidence on techniques challenged the use of autogenous bone within PLIF, PEEK over HA/PA66 cages, and found no advantages in unilateral decompression within TLIF. There was minimal clinical difference in evidence assessing MIS (minimally invasive) vs. open-TLIF or unilateral vs. bilateral pedicle screw fixation (PSF). Conclusions: This is the first systematic review of the multilevel LIF literature, revealing that while pooled data favored TLIF, a publication bias was detected, and comparative evidence reported advantages for lateral and oblique approaches. Given the lack of conclusive evidence, robust study designs are needed to guide clinical decision-making for multilevel lumbar pathology. Full article
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