1. MINIMA INVASION CIRUGIA DE COLUMNA

2. PERSPECTIVA HISTORICA 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. CIRUGIA CONVENCIONAL (TECNICAS TRADICIONALES) 3. PERSPECTIVA HISTORICA EVOLUCION CIRUGIA MINIMAMENTE INVASIVA 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 4. PERSPECTIVA HISTORICA ACTUALIDAD CIRUGIA MINIMAMENTE INVASIVA 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 5. MISS ABORDAJE QUIRURGICO 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. LESION CORREDOR QUIRURGICO 6. MISS ABORDAJE QUIRURGICO 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. LESION CORREDOR QUIRURGICO 7. MISS ABORDAJE QUIRURGICO 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. CORREDOR QUIRURGICO LESION 8. FUNDAMENTO FISIOLOGICO 1. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal 2010; 19:316324. 2. Datta, G. et al. Back pain and disability after lumbar laminectomy: Is there a relation to muscle retraction. Neursurgery 2004: 20-35. 9. 1. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal 2010; 19:316324. 2. Datta, G. et al. Back pain and disability after lumbar laminectomy: Is there a relation to muscle retraction. Neursurgery 2004: 20-35. 10. FUNDAMENTO FISIOLOGICO 1.- Necrosis e inflamacin evidentes 1 semana. 2.- Cambio fibrtico 3 y 6 semanas. 3.- Degeneracin grasa 12 y 24 semanas. 11. FUNDAMENTO FISIOLOGICO 3 Grupos: Grupo A: 2 horas continuas. Grupo B: 1 hora y 5 minutos descanso. Grupo C: 40 minutos y 5 minutos descanso. Examen inmunohistoqumico, electrofisiologico y microcscopico en 48 horas, 1 semana, 6 semanas. CPK >Grupo A > Grado de Regeneracion y Dao tisular. 12. FUNDAMENTO FISIOLOGICO 20 pacientes; Presin intramuscular Medicin a 5, 30, 60 min en la ciruga Biopsia muscular antes y despus de la retraccin utilizando ATP con birrefringencia. Resultados: Aumento significativo de AMPC durante la retraccin Retraccin < disminucin del ATP 13. PATOLOGIAS 1. Datta, G. et al. Back pain and disability after lumbar laminectomy: Is there a relation to muscle retraction. Neursurgery 2004: pp 20-35. 14. BENEFICIOS Incision Retraccion Muscular Cicatriz Sangrado Estancia Dolor 1. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal 2010; 19:316324. 2. Datta, G. et al. Back pain and disability after lumbar laminectomy: Is there a relation to muscle retraction. Neursurgery 2004: 20-35. 15. MISS Microscopa Percutaneo Endoscopa Laparoscopa Accesos Tubulares Procedimientos Hibridos 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 16. MISS 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. Microscopa INCISIONES PEQUEAS: 1.- Microdisectomia 17. MISS 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. SIN INCISION: 1.- Quemonucleolisis 2.- Nucleotomia 3.- Vertebroplastia 4.- Xifoplastia 5.- Bloqueo 6.- Ablacion Percutaneo 18. MISS 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. PUERTA Y LLAVE: 1.- Discectomia Toracica 2.- Discectomia Lumbar 3.- Deformidad Toracica 4.- Manejo de Trauma Endoscopa 19. MISS 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. ESPACIO VIRTUAL: 1.- Discectomia Toracica 2.- Discectomia Lumbar 3.- Deformidad Toracica Laparoscopa 20. MISS 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. MINIMA RETRACCION Y DISECCION MUSCULAR: 1. METRx 2. MIRA 3. AccuVision Minimally Invasive spine System 4. NAPA Minimally Invasive Retractor System 5. Serengeti Retractor System 6. Luxor Minimally Invasive Retractor System Accesos Tubulares 21. MISS 1. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 2. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. RECOMBINADOS Y NUEVAS TECNOLOGIAS: 1. Discectomia Percutanea Asistida con Laser. 2. X-STOP 3. AxiaLIF Procedimientos Hibridos 22. ENFOQUE MISS FUSION DESCOMPRESION RECONSTRUCCIO N RESECCION 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. 23. ENFOQUE MISS 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. FUSION Fusin intersomtica Postero Lateral (DLIF). Fusion Extremo Lateral (XLIF). Fusin Posterior Lumbar (PLIF). Fusin Transforaminal (TLIF). Fusion Anterior Lumbar (ALIF). Fusion Axial (AxiaLIF). Fusion Extraforaminal (ETLIF). 24. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. PLIF FUSION 1936 Mercer Fusin Intersomtica 1940 PLIF Autoinjerto apfisis espinosa 1951 Cloward 331 Pacientes 85% satisfaccin; amplia variabilidad en sus resultados clnicos y las tasas de fusin Modificaciones de la tcnica intercorporal: Cresta Ilaca, Injertos Autlogos, Aloinjerto Oseo, Implantes Metalicos, Fibra de Carbono Alta tasa de Pseudoartrosis; Uso adems, de Tormillos transpediculares. GENERALIDADES 25. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. PLIF FUSION Ventajas: 1.- Amplia zona de contacto de injerto seo intervertebral 2.- Mejor suministro de sangre al injerto centro vertebral 3.- Centro de fusin prximo al centro de movimiento 4.- Mejora el intercambio de carga entre el injerto y el hueso 5.- Descompresin completa del agujero intervertebral y raz nerviosa 6.- Restauracin de distancia entre cuerpos y la altura neural foraminal 7.- Mantener la lordosis segmentaria en el segmento fusionado VENTAJAS 26. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. PLIF FUSION 1.- Espondilolistesis 2.- Hernia discal de novo o recurrente 3.- Ciruga lumbar fallida 4.- Inestabilidad segmentaria 5.- Enfermedad degenerativa del disco INDICACIONES 27. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. PLIF FUSION Gill y Blumentahal: 238 pacientes Fusin slida en el 92 % Sin dolor 61% Ligero Dolor 26 % 2 aos: 13% dolor residual Steffee y Brantigan: 169 pacientes 86 % Espondilolistesis / TF 91.5 % 80 % Cirugia Lumbar Fallida / TF 92 % 78 % Estenosis Espinal / TF 97 % Lanzino: revisin de 2816 casos Excelente resultado en 85 % Tasa de Fusin 89% Tasa de fracaso 13 % RESULTADOS 28. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. TLIF 1) Descompresin Neural via Transforaminal 2) Eliminacin de la articulacin facetaria 3) Fusin intersomtica 4) Tornillos via pedicular FUSION OBJETIVOS 29. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. TLIF Menor tasa complicaciones 85 A < 45 A SINTOMA AXIAL-RADICULAR (45%) RADICULAR (24%) NIVEL L4-L5 (90%) L5-S1 (5%) TIEMPO QUIRURGICO 193.25 MIN 95 MIN SANGRADO 462 ML 250 ML ABORDAJE IZQUIERDO (62%) DERECHO (38%) FUSION 45. ENFOQUE MISS 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. DESCOMPRESION Disectomia Endoscopica Disectomia Microscopica Laminectoma Foraminotomia Disectomia Endoscopica Toracica Videoasistida Disectomia Percutanea Laser Asistida Disectomia Percutanea 46. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. DESCOMPRESION Disectomia Microscopica 1.- Ventana Interlaminar Microscopio 2.- Indicaciones: Hernia discal Hernia bisegmentaria Adyacente Atrapamiento de la razi Estenosis de canal lateral 3.- Contraindicaciones: Estenosis del canal espinal > 2 discos nivel Espacio interlaminar GENERALIDADES 47. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. DESCOMPRESION 1.- 1997 Dilatador y retractor tubular Endoscopio discectoma 2.-Ventajas Reduce el trauma del tejido Visualizacin Integral Visualizacin directa de la raz nerviosa Permite la descompresin sea 3.- Desventajas Curva de aprendizaje Ruptura Dural difcil de reparar Disectomia Endoscopica GENERALIDADES 48. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. Disectomia Endoscopica 49. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. Laminectomia Endoscopica 1.- Menor trauma a los tejidos blandos 2.- disminuye lesin muscular 3.- Mejora la visualizacin de las laminas 4.- Mejora el grado de descompresin laminar hasta 45% GENERALIDADES 50. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. Laminectomia Endoscopica RESULTADOS 51. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. Foraminotomia RESULTADOS 52. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. DESCOMPRESION Foraminotomia RESULTADOS 53. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. DESCOMPRESION Disectomia Percutanea Laser Asistida 1.- Fue descrita por primera vez en 1984 Colocacion percutnea en disco Fibra ptica se introduce energa laser al interior del disco 2.- La energa laser: Pequeas cargas de energa Se realizan pulsaciones rtmicas Aspiracin e irrigacin 3.- Mejora de la sintomatologa hasta en 70 a 80 %. 4.- Complicaciones: Discits Perforacin aortica de V cava y vasos iliacos Perforacin de rganos abdominales Sndrome de la cauda equina. GENERALIDADES 54. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. Disectomia Percutanea 1.- Fue diseada en 1975: Nucleotomia parcial mediante un abordaje postero-lateral. 2.- En 1983 Kambin y Gellman disean el abordaje dorso-lateral. 3.- Indicaciones Pacientes con enfermedad en un solo nivel Disco rotos con fragmentos contenidos Espacios intervertebrales amplios Protrusin discal leves GENERALIDADES 55. ENFOQUE MISS 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. RECONSTRUCCION Xifoplastia. Vertebroplastia. Laminoplastia. 56. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. 1.- Deramond et al (1987) 2.- Indicaciones: Dolor causado por la osteoporosis Fracturas por compresin Dolor por MAVS Dolor por tumores a invasin al canal 3.- Contraindicaciones: Infeccin sistmica o medular Ditesis hemorrgica no corregida Deficit cardiopulmonar Fractura relacionada con compromiso del canal RECONSTRUCCION Vertebroplastia GENERALIDADES 57. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. 4.- Complicaciones: Incidencia: radiculopata, 4%; compresin 0,5%) RECONSTRUCCION Vertebroplastia GENERALIDADES 58. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. RECONSTRUCCION Vertebroplastia 59. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. RECONSTRUCCION Xifoplastia 1.- Es una variante de la vertebropalstia. Se infla un baln en el espesor de la vertebra colapsada Restaura la altura y evita la xifosis posterior Seguida de inyeccin de polimetilmetacrilato 2.- Riesgos Tiene el riesgo de la extravasacin del cemento Compresin por efecto de masa Radiculopatia Alteraciones en los segmentos adyacentes. GENERALIDADES 60. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. Xifoplastia 61. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. RESECCION ENFOQUE MISS 62. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. RESECCION Reseccion Intra y Extradural Incision bilateral Retraccion muscular Laminectoma multinivel Dolor Menor prdida de sangre Alta velocidad de recuperacin Integridad estructural de la columna vertebral GENERALIDADES 63. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. Reseccion Intra y Extradural 64. Reseccion Intra y Extradural 65. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. RESECCION Reseccion Intra y Extradural 66. 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14, November 2002. 2. Oppenheimer, J. Decastro, I. Mcdonnel, M. Minimally Invasive Spine Technology and Minimally Invasive Spine Surgery: A Historical Review. Neurosurgery Focus; Volume 27; Pag 1-15: September 2009. 3. Benzel, O et al. Minimally Invasive Spine Surgery, Springer Media, 2009. 4. ShunWu, F. ZhiJun, H. Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. European Spine Journal; 19:316324, 2010. 5. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013. RESECCION Reseccion Intra y Extradural 67. FUTURO HIBRIDOS 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14 2. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013 68. FUTURO HIBRIDOS 1. Jaikumar, S. et al. History of Minimally Invasive Spine Surgery. Neurosurgery 51; Supplement 2:1-14 2. Park, P. La Marca, F. Combined Hybrid Open and Minimally Invasive Surgical Correction of Adult Thoracolumbar Scoliosis: A Retrospective Cohort Study. Neurosurgery 72:151159, 2013