Spine: minimally invasive techniques.

Minimally invasive spine surgery decompression, arthrodesis, and instrumentation techniques are now being applied in a wide variety of percutaneous, laparoscopic and minimal access procedures. There is currently little longitudinal long-term data on these procedures to document their efficacy, indications, limitations or complications as compared to standard open techniques. Further complicating such direct comparisons is that widely used spine outcomes instruments often do not capture the relative benefits of these new procedures. It is only through randomized trials that the potential benefits of these procedures be substantiated in order to justify the sometimes significant increased costs associated with them.