Review Article
Minimally Invasive Spine Surgery for Degenerative Lumbar Diseases: Current Advances and Future Perspectives
Zhi Liang*
Issue:
Volume 1, Issue 2, December 2026
Pages:
40-45
Received:
14 June 2026
Accepted:
10 July 2026
Published:
10 August 2026
Abstract: Degenerative lumbar diseases (DLDs), encompassing lumbar disc herniation, lumbar spinal stenosis, degenerative spondylolisthesis and degenerative lumbar scoliosis, constitute a predominant global source of chronic low back pain and radiculopathy. Such conditions markedly degrade patients’ quality of life and place a heavy socioeconomic burden on healthcare systems. Conventional open posterior lumbar surgery delivers satisfactory spinal decompression and interbody fusion, yet it is plagued by prominent drawbacks: severe paraspinal muscle injury, substantial intraoperative blood loss, intractable postoperative pain, longer hospital stays, and an increased risk of adjacent segment disease. Fueled by advances in surgical navigation, spinal endoscopy and intraoperative neuromonitoring, minimally invasive spine surgery (MISS) has achieved remarkable progress. These minimally invasive procedures retain the integrity of the posterior ligamentous complex, drastically lessen soft tissue trauma, and enable accelerated early postoperative rehabilitation. This narrative review was conducted to systematically characterize the state-of-the-art application of MISS for DLD management. High-quality peer-reviewed studies were retrieved and synthesized to summarize mainstream MISS techniques, operative workflows, perioperative clinical outcomes, surgical complications and inherent technical limitations. We further outline promising developmental directions for minimally invasive lumbar interventions. This work aims to furnish evidence-based references for clinical therapeutic decision-making and facilitate future translational research related to DLD minimally invasive treatment.
Abstract: Degenerative lumbar diseases (DLDs), encompassing lumbar disc herniation, lumbar spinal stenosis, degenerative spondylolisthesis and degenerative lumbar scoliosis, constitute a predominant global source of chronic low back pain and radiculopathy. Such conditions markedly degrade patients’ quality of life and place a heavy socioeconomic burden on he...
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Research Article
Secondary Dynamization by Ilizarov External Ring Fixator After Failure of Diaphyseal Nonunion with Intramedullary Nailing Keeping Nail in Situ
Issue:
Volume 1, Issue 2, December 2026
Pages:
46-57
Received:
28 July 2026
Accepted:
6 August 2026
Published:
22 August 2026
DOI:
10.11648/j.ajot.20260102.12
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Abstract: Background: Diaphyseal nonunion following failed intramedullary nailing is a challenging orthopedic condition. Secondary dynamization using an Ilizarov external ring fixator while retaining the intramedullary nail may improve fracture healing and functional recovery. Objective: To evaluate the clinical and radiological outcomes of secondary dynamization using an Ilizarov external ring fixator after failure of diaphyseal nonunion with intramedullary nailing while keeping the nail in situ. Methods: This prospective study was conducted at the Department of Orthopaedic Surgery, NITOR, Dhaka, Bangladesh, from June 2024 to May 2026. Thirty patients with diaphyseal nonunion following failed intramedullary nailing were treated with secondary dynamization using an Ilizarov external ring fixator while retaining the intramedullary nail. Clinical, radiological, and functional outcomes were analyzed using SPSS version 22.0. Results: The mean age of the participants was 35.7 ± 9.2 years, and 80.0% were male. Fracture union was achieved in 93.3% of patients, with a mean union time of 18.8 ± 3.4 weeks. At final follow-up, 86.7% achieved full weight bearing, 80.0% regained full range of motion, and the mean VAS pain score improved from 7.4 ± 1.2 to 1.9 ± 0.8. Pin tract infection was the most common complication (23.3%), and infection was significantly associated with persistent nonunion (p = 0.014). Conclusion: Secondary dynamization with an Ilizarov external ring fixator while retaining the intramedullary nail is an effective and reliable treatment for diaphyseal nonunion, providing a high union rate and good functional outcome.
Abstract: Background: Diaphyseal nonunion following failed intramedullary nailing is a challenging orthopedic condition. Secondary dynamization using an Ilizarov external ring fixator while retaining the intramedullary nail may improve fracture healing and functional recovery. Objective: To evaluate the clinical and radiological outcomes of secondary dynamiz...
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