I generally do not recommend a “minimally invasive” system to perform a fusion. The whole purpose of a posterior fusion is to have bone grow between the two facets and transverse processes. This requires preparation of these bony structures and the minimally invasive systems do not allow for great preparation of these surfaces.
In addition, the purpose of a minimally invasive fusion is to “preserve the muscles”. The whole point of a fusion is to get the two separate vertebrae to grow together. The small muscles that cross these joints are not needed after a successful fusion so preservation seems besides the point. The other fact is that the insertion surface area of these small muscles has to be removed to gain bone surface for the fusion. Preservation of the small muscles is not needed and actually contraindicated for successful posterior fusion.
In addition, for a younger active individual, I recommend the TLIF (intradiscal fusion) along with the posterior fusion as the fusion mass is stronger with a greater chance of a solid fusion. This can be performed by a “minimally invasive” procedure but my preference is for a smaller incision in the midline.
Although not really relevant, the cosmetic nature of a central incision is much more pleasing than two para-midline incisions.
Dr. Corenman
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.