“Selection, planning and execution of minimally invasive surgery in adult spinal deformity correction”

Minimally invasive surgery (MIS) for correction of adult spinal deformity was developed to address the high rate of medical and surgical complications rate in open surgical treatment of increasingly aging and frail patient population. In the past decade, MIS group within the International Spine Study Group (ISSG) has been in the forefront of the application of MIS techniques to fulfill the well-established principles of ASD surgery. These efforts have resulted in landmark studies. Here, we review these studies that encompass all aspects of MIS surgical treatment of ASD including patient selection with Minimally Invasive Spinal Deformity Surgery (MISDEF) and MISDEF-2 algorithms, surgical planning with anterior column realignment classification and the Minimally Invasive Interbody Selection Algorithm (MIISA), and surgical execution with Spinal Deformity Complexity Checklist (SDCC). We will highlight that with careful selection, diligent planning and meticulous execution the MIS techniques can treat patients with ASD, abiding to correction principles and radiographic parameters.