Expanding the Horizons of Minimally Invasive Spine Surgery: Experience of the Destandau Technique for the Treatment of Multiple Spinal Diseases

Minimally invasive spine surgery is rapidly gaining popularity owing to its versatile nature. Traditionally prolapsed disc has been the most common pathology targeted using this technique. However, its utility for various other pathologies has also been shown in studies. Here we present our experience of using this technique for various spinal pathologies apart from prolapsed discs. This is a retrospective study in which patients operated by a single surgeon from January 2019 to April 2023 were included. Cases which required conversion to open technique were excluded. Intraoperative findings and post-operative courses were obtained from patient records. A total of 47 cases were included in the study, of which 29 were male and 18 were female. Various pathologies treated include- intradural extramedullary tumors – 23, hypertrophied/ossified ligamentum flavum- 9, arachnoid cysts- 6, dermoid/epidermoid- 4, detethering of cord- 3 and posterior cervical decompression for an ossified posterior longitudinal ligament in 2 patients. The average duration of surgery was 2.1+1.2 hrs and the mean intraoperative blood loss was 138.4+ 59.1 ml. The mean hospital stay was 2.3+0.9 days. Two patients had superficial wound infection and none of the operated patients had cerebrospinal fluid leakage. Re-exploration was not required in any of the operated patients. Minimally invasive techniques for dealing with multiple pathologies involving the spine are as good as traditional open techniques with some additional advantages of lesser tissue trauma, early return to work etc. However, one must overcome the steep learning curve before adopting them in day-to-day practice.