Minimally invasive spine surgery (MISS) has captured the attention of not just the medical field but also that of the general population. MISS relates to management of focal lesions using ports in the form of endoscopes and tubular retractors. New frontiers are broken every day and situations once contraindicated are tackled with minimally invasive surgery (MIS) with astounding success and minimal morbidity. The Indian subcontinent in particular and the world in general has witnessed a sea-change in the ever-growing interest, enthusiasm, success, acceptance as well as surgical entrepreneurship in this super-specialty. This special issue carries a narrative of the current state-of-art context of ‘what’s happening now in Indian MISS scenario?’
The issue carries an excellent overview of classifying complications in endoscopy by Krishnan et al. [1] which brings much needed synthesis and clarity to the topic. The extraordinary reaches of the endoscope in approaching disc herniations in hidden areas by Bhanot et al. [2] enhance the stature of the issue. Arthrospine, a material concept developed by Kaushal and Kaushal [3] amalgamates the ‘new and old’ in tempering the application of conventional instruments through the endoscope.
The inherent philosophy of tubular approach preserves the midline posterior tension band, namely the supraspinous and interspinous ligaments which offer close to 35% resistance to flexion load. Hybrid MIS, as described by a manuscript by Kulkarni et al. [4], exploits this opportunity in establishing a possibility of decompression alone adjacent to a fused level.
The growing interest in biportal endoscopy (UBE) is reflected in the amazing number of original articles getting generated from the MISSAB members. Technique of solving hidden zone pathologies using UBE is represented meticulously by Pestonji and Gunjotikar [5]. Delat et al. [6] take us on a voyage of anatomy, skills, learning curve etc required to master the technique of UBE through the large volume of sheer experience and comparing the UBE outcomes with micro-endoscopic discectomy.
Alshaibi et al. [7] take us through a journey of exoscope visualization, navigation guidance and precision in spine surgery. Some exciting treatment options in the management of low back pain employing radiofrequency by Wu et al. [8] need a special mention. Doors of MIS have interestingly opened in the field of scoliosis. How do these mini-open techniques fare against the gold-standard conventional big exposures?
This issue also highlights a stream of other novel techniques and case reports, quite worthy of assimilating and adopting in surgical practice.
Overall, the readers of the journal are exposed to a rich feast of novel and innovative thought-processes. In this edition, the followers of one exclusive technique get an opportunity to peep into the rooms of another technique to learn as well as realize their deficiencies and thereby get encouraged to forge ahead.
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