The Global Spine Journal has released a special supplemental issue dedicated to the 6 Ts of minimally invasive spine surgery (MISS). This special issue is guest edited by Roger Härtl, M.D., professor of Neurological Surgery and Director of Spinal Surgery and Neurotrauma at the Weill Cornell Brain and Spine Center and Director of the Weill Cornell Medicine Center for Comprehensive Spine Care. Härtl also serves as an associate editor of the publication.
Special Issue on 6 Ts of Minimally Invasive Spine Surgery
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The 6 Ts of MISS are Target, Technology, Technique, Training, Testing, and Talent. These are surgery and surgeon-related features required for successful outcomes. These aspects include targeting appropriate patients and procedures, specialized technology, surgical skills and techniques and procedures, adequate training and teaching, testing of surgical outcomes, and surgical talent.
Härtl believes that there is a strong future for minimally invasive spine surgery with the 6 Ts being important factors that must be considered for success with the more complex surgical methods.
A statement by Härtl posted on the Global Spine Journal website described the importance of the procedures, “Minimally invasive spinal surgery is a suite of technology-dependent techniques and procedures that reduces local operative tissue damage and systemic surgical stress enabling earlier return to function striving for better outcomes than traditional techniques.”
The issue includes several articles on each point of the 6 Ts to provide the current status and understanding in the field. Topics covered include predictive factors for lateral lumber fusion failure, augmented reality, endoscopic techniques, curriculum development, comparisons of minimally invasive and open procedures for TLIF, and metrics development, among many others.
This issue is sure to bring minimally invasive spine surgery to readers of the journal who may have been considering the procedures but unsure of the effectiveness or what technology is available to support it. By making the techniques and technology more accessible, as this publication does, will spark the curiosity of many who have wanted to learn more.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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