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Oblique Anterior Column Realignment for Minimally Invasive Adult Spinal Deformity Correction: An Illustrative Case Series and Systematic Literature Review With Meta-Analysis.

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Circumferential Minimally Invasive Adult Spinal Deformity Surgery: A Systematic Review With Key Concepts and

Marcos Real1, Logan H Sigua1, Matthew R Allen1

  • 1Department of Neurological Surgery, University of California, San Diego, California, USA.

World Neurosurgery
|January 6, 2026
PubMed
Summary

Minimally invasive surgery for adult spinal deformity (ASD) offers comparable alignment to open surgery with fewer complications. However, long-term risks like pseudarthrosis require careful patient selection for circumferential MIS (cMIS) in ASD.

Keywords:
Adult degenerative scoliosisAdult spinal deformityApproach selectionMinimally invasiveNeurosurgerySpinecMIS

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Area of Science:

  • Spine Surgery
  • Orthopedic Surgery
  • Minimally Invasive Procedures

Background:

  • Open techniques historically dominated adult spinal deformity (ASD) surgery.
  • Minimally invasive surgery (MIS) advances have increased its use for ASD.
  • The efficacy of circumferential MIS (cMIS) for ASD correction compared to open surgery is under investigation.

Purpose of the Study:

  • To systematically review the core principles and techniques for successful cMIS outcomes in ASD.
  • To evaluate the safety and effectiveness of cMIS for ASD.
  • To compare cMIS outcomes with traditional open surgical approaches.

Main Methods:

  • Systematic literature search adhering to PRISMA guidelines (PubMed, Embase, Cochrane).
  • Inclusion of peer-reviewed studies with ≥5 patients undergoing cMIS for ASD.
  • Focus on postoperative outcomes: spinopelvic alignment and complication rates.

Main Results:

  • 25 studies (2,565 patients) met inclusion criteria.
  • cMIS significantly improved patient-reported outcomes (VAS, ODI) and spinopelvic alignment.
  • cMIS showed reduced blood loss and complications versus open/hybrid, but higher long-term pseudarthrosis rates.

Conclusions:

  • Circumferential MIS (cMIS) is a safe and effective technique for select ASD patients.
  • cMIS achieves significant improvements in spinal alignment and patient outcomes.
  • Careful patient selection is crucial to mitigate risks such as long-term pseudarthrosis.