Corresponding Author

Tarek Aly

Subject Area

Degenerative, Lumbosacral spine

Document Type



Background Data: Using less invasive procedures during surgery for thoracolumbar and lumbar problems has grown in importance. Miniopen or minimally invasive procedures lessen intraoperative bleeding and postoperative back pain compared to open techniques. Uncertainty persists on whether minimally invasive surgeries cause less paraspinal muscle injury than open surgery. According to some reports, compared to open surgery, minimally invasive surgeries (MIS) might result in less muscle atrophy and fat infiltration. Purpose: This study aimed to find whether minimally invasive posterior lumbar spine surgery can lessen paraspinal muscle damage, restrict alterations in muscular structure and function, and improve functional outcomes. Study design: A literature review. Patients and Methods: A cross-referencing and extra manual search of the literature in PubMed and MEDLINE, the Cochrane Library databases, and Google Scholar search was conducted. Studies comparing traditional open surgery with minimally invasive or percutaneous procedures were included. In total, 40 studies comparing both techniques were found and analyzed. The muscle state assessment was extended up to two years in human studies. Results: Eleven studies were conducted on experimental animals, and the remaining studies were either case-control studies, case series, or comparative studies comparing the size of the multifidus muscle between patients with various lumbar spine disorders treated either conventionally or using minimally invasive techniques. Conclusion: Even though the degree of evidence is relatively weak, the present study revealed that the minimally invasive posterior spinal techniques have some advantages over the open techniques, such as less damage to the MF muscle, which is supported by the literature review. The association between changes in muscular structure and pain, strength, and quality of life needs to be better understood via research. These investigations ought to focus on the surgical approach. (2022ESJ257)


Paraspinal muscle, Open, Percutaneous, Functional Outcome, Minimally Invasive.