Minimal Invasive Spine Surgery – Learning a new technique

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Clinical Challenge

Learning a new technique and overcoming the learning curve for Minimal Invasive Spine Surgery

One challenge spine surgeons are facing is the increasing demand for safety – not only from patients, but also from healthcare providers and paying parties such as insurance companies. The other challenge is to increase efficiency and, where possible, to lower hospital costs without risking that these savings affect patient safety. That is why surgeons have to focus on questions such as how to perform surgery with minimal blood loss and how to perform Minimally Invasive Spine Surgery (MISS). A smaller incision means reduced damage to surrounding tissue,1,2 less blood loss,1-3 and decreased scarring.1 In addition, this reduction in tissue trauma yields lower complication rates,1,4 better pain outcomes,2,4 and fewer infections1, which translate into a faster recovery time and hospital discharge for the patients.

Clinical facts about MISS

Dr. Andreas Korge

One important thing is that you have to accept a learning curve. And you have to accept that if you start a new technology, you will have a couple of complications in the beginning.

Dr. Andreas Korge

Head of Spine Center and Back Institute, Schoen Clinic Munich, Germany

Advanced Visualization Systems as a key success factor of MISS

Minimally Invasive Spine Surgery delivers benefits to surgeons and patients. Plus, the shorter OR times8 and lower cost8,9 of MISS mean that the practice can be more efficient and cost-effective, enabling the hospital or treatment center to reduce utilization of resources and to increase surgical case volume.5 A key factor in the success of MISS is the choice of visualization system. Surgical microscopes such as the TIVATO® 700 from ZEISS are complete Advanced Visualization Systems. These sophisticated systems offer numerous benefits over both the endoscope and the loupes.

Discover our interactive demo

Use the interactive demo to find out about the new functionalities of the TIVATO 700 from ZEISS and discover how the Advanced Visualization System can support you. Simply switch from functionality to functionality and drag the picture to move or position the device.



  • Benefits of MISS

  • How to start with MISS?

  • The future of MISS

More challenges in spine surgery

  • 1

    Orndorff DG et al. Minimally invasive approaches for spine surgery. J Spinal Res Foundation 2013;8:49-55

  • 2

    Wang J et al. Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Eur Spine J 2010;19:1780-1784

  • 3

    Goldstein CL et al. Comparative effectiveness and economic evaluations of open versus minimally invasive posterior or transforaminal lumbar interbody fusion: A systematic review. Spine 2016;41:S74-S89

  • 4

    Mobbs RJ et al. Minimally invasive surgery compared to open spinal fusion for the treatment of degenerative lumbar spine pathologies. J Clin Neursci 2012;19:829-835

  • 5

    Douglas G. Orndorff, M.D. et al., “Minimally Invasive Approaches For Spine Surgery”, Journal Of The Spinal Research Foundation 8, no. 1 (2013): 49–55

  • 6

    Christina L. Goldstein, Frank M. Phillips and Y. Raja Rampersaud, “Comparative Effectiveness And Economic Evaluations Of Open Versus Minimally Invasive Posterior Or Transforaminal Lumbar Interbody Fusion”, SPINE 41, no. 8 (2016): S74–S89, doi:10.1097/brs.0000000000001462

  • 7

    Kern Singh et al., “A Perioperative Cost Analysis Comparing Single-Level Minimally Invasive And Open Transforaminal Lumbar Interbody Fusion”,The Spine Journal 14, no. 8 (2014): 1694-1701, doi:10.1016/j.spinee.2013.10.053

  • 8

    Singh K et al. A perioperative cost analysis comparing single-level minimally invasive and open transforaminal lumbar interbody fusion. Spine J 2014;14:1694-1701

  • 9

    Wang MY et al. Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients. J Spinal Disord Tech 2012;25:324-328