Evolution of the Minimally Invasive Spinal Deformity Surgery Algorithm: An Evidence-Based Approach to Surgical Strategies for Deformity Correction.

Minimally invasive surgery (MIS) is an alternative to open surgery for adult spinal deformity correction. However, not all patients are ideal candidates for MIS correction. The minimally invasive spinal deformity surgery algorithm is a systematic and reproducible decision-making framework for surgeons to identify patients appropriate for deformity correction by MIS techniques. Key spinopelvic parameters including sagittal vertical axis, pelvic tilt, pelvic incidence to lumbar lordosis mismatch, and coronal Cobb angle are used to guide surgeons toward three treatment classes ranging from MIS to traditional open approaches. This article updates the minimally invasive spinal deformity surgery algorithm and presents representative cases.