Learning curve and complications of minimally invasive spine surgery

Minimally invasive spine surgery (MISS) techniques may provide relevant clinical results with less approach-related morbidity than conventional open surgery. These techniques can treat patients with minor complications and have faster recovery times. However, muscle-sparing or bypassing access techniques have some technical hurdles and risks unique to novel approaches, including small surgical exposure, restricted working corridors, and limited surgical devices. The most common complications are dural tears, incomplete decompression, instrument malposition, hematoma, and infection related to a minimally invasive approach. Therefore, surgeons aspiring to perform MISS should overcome the learning curve to achieve technical proficiency and reliable outcomes. Systematic training courses and technological developments should be conducted to overcome these barriers. The present review describes the most common complications of MISS and how to prevent them.