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Updated: Apr 3, 2026
Novel Mini-open Transforaminal Lumbar Interbody Fusion
Published on: June 6, 2025
Minimally Invasive Spinal Surgery in the Elderly: Does It Make Sense?
Mohammed F Shamji1, Christina L Goldstein, Michael Wang
1*Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada; ‡Department of Surgery and §Techna Research Institute, University of Toronto, Toronto, Ontario, Canada; ¶Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri; ‖Department of Neurosurgery, University of South Florida, Tampa, Florida; #Department of Neurological Surgery, University of Miami, Miami, Florida; **Toronto Western Research Institute, Toronto, Ontario, Canada.
Minimally invasive surgery (MIS) for lumbar degenerative disease is safe and effective for elderly patients over 65. MIS spinal procedures improve pain and disability, offering a viable option for this population.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Lumbar degenerative disease encompasses stenosis, spondylolisthesis, and scoliosis, causing significant pain and disability.
- Surgical intervention can effectively manage pain and improve quality of life in selected patients.
- Minimally invasive surgery (MIS) aims to reduce surgical impact and complications while achieving spinal objectives.
Purpose of the Study:
- To evaluate the utility and safety of MIS spinal surgery in elderly patients (>65 years).
- To assess MIS for lumbar decompression, interbody fusion, and deformity correction in this demographic.
Main Methods:
- Systematic review of 2 studies for MIS lumbar decompression.
- Systematic review of 4 studies for MIS lumbar interbody fusion.
- Narrative review for adult degenerative deformity correction using MIS techniques.
Main Results:
- MIS lumbar decompression showed significant improvements in leg pain (3.4 points) and disability (19 points), with 3% durotomy.
- MIS lumbar interbody fusion demonstrated robust improvement in leg pain (3.4 points) and back pain (7.2 points), with 5% durotomy.
- MIS techniques are feasible for degenerative deformity correction with acceptable union and complication rates.
Conclusions:
- Elderly patients (>65 years) can benefit from MIS interventions for symptomatic lumbar degenerative spinal disease.
- MIS spinal surgery is a safe and effective option for decompression, fusion, and deformity correction in older adults.
- Despite largely low-quality evidence, elderly patients should not be excluded from considering MIS for lumbar degenerative conditions.
