PT  - JOURNAL ARTICLE
AU  - Sarikonda, Advith
AU  - Sivaganesan, Ahilan
AU  - Qureshi, Sheeraz
TI  - Advanced Visualization in Minimally Invasive Spine Surgery: The Ergonomics, Economics, and Evolution of Camera-Based Tubes and Retractors
AID  - 10.14444/8643
DP  - 2024 Aug 26
TA  - International Journal of Spine Surgery
PG  - 8643
4099  - https://www.ijssurgery.com/content/early/2024/08/26/8643.short
4100  - https://www.ijssurgery.com/content/early/2024/08/26/8643.full
AB  - Background Tubular spine surgery has emerged as a hallmark of minimally invasive spine (MIS) procedures. In recent years, thanks to technological advances, tubular dilators and retractors have been integrated with digital cameras to allow for ergonomic, high-definition visualization of the surgical field.Objective To detail the evolution, ergonomics, economics, and outcomes of camera-based tubular spine surgery, spanning the origins of MIS tubular techniques to the current use of operative microscopes and tube-mounted digital cameras (TMDCs).Methods This is a narrative review of studies examining the evolution of tubular spine surgery as well as its most recent advances, with a particular emphasis on advances in visualization of the surgical field.Results Despite early resistance to tubular techniques due to a steep learning curve, minimally invasive tubular approaches are being increasingly adopted by the mainstream spine surgical community, which has resulted in an expansion of both indications and procedural modalities. This can largely be attributed to the increased quality of visualization, as evidenced by improvements in microscopes as well as emerging technologies like exoscopes and TMDCs. Tubular MIS procedures have also achieved superior efficacy compared with open surgical approaches for the treatment of several spinal pathologies while allowing for improved ergonomics, which may have lasting consequences on surgeon longevity.Conclusions Advances in visualization technologies have allowed tubular surgery to become an effective, ergonomic, and muscle-sparing alternative to open spine surgery. Further research is necessary to quantify the true costs and outcomes associated with nascent TMDC technology.Clinical Relevance This work elucidates developments in visualization for tubular spine surgery.Level of Evidence 5.