Certain medical conditions and patient characteristics may make traditional open surgery a more suitable approach for spinal procedures. These include severe spinal instability, significant deformity, advanced osteoporosis, active infections near the surgical site, morbid obesity, certain anatomical variations, and specific complex revisions of previous spinal surgeries. Patients with uncontrolled bleeding disorders or those unable to tolerate general anesthesia may also be better suited for alternative treatments.
Careful patient selection is paramount for successful spinal surgery. Identifying individuals for whom minimally invasive techniques are less appropriate helps ensure optimal outcomes and minimizes potential complications. Traditional open surgery, while more invasive, offers a wider range of surgical options and greater access to complex spinal anatomies in these specific situations. The development of advanced imaging techniques and a deeper understanding of spinal biomechanics have contributed to improved patient selection criteria over time.
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