The Current Status of Minimally Invasive Surgery for Adolescent Idiopathic Scoliosis: A Narrative Review of Current Literature

Abstract Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity affecting 0.47%–5.2% of adolescents. Surgical intervention remains the mainstay of treatment for progressive curves, with the open posterior midline (OPM) approach being the traditional standard. In recent years, the minimally invasive scoliosis surgery (MISS) approach has gained increasing attention for its potential to minimize surgical trauma while maintaining effective deformity correction. This narrative review compares the outcomes of MISS and OPM in AIS management based on literature published from 2009 to 2024. Thirteen studies meeting inclusion criteria were analyzed. Both MISS and OPM demonstrated comparable coronal plane correction, while sagittal alignment results varied among studies, with some favoring MISS but without clear clinical significance. MISS generally employed a higher screw density and achieved similar functional and patient-reported outcomes compared to OPM. Although the MISS technique was associated with longer operative times, it offered notable perioperative advantages, including reduced intraoperative blood loss and shorter hospitalization. Complication rates were comparable between the two approaches. Overall, MISS provides similar radiographic and clinical results to OPM, with certain perioperative benefits, supporting its role as a viable alternative for AIS correction. Further large-scale, long-term studies are warranted to validate these findings and refine patient selection criteria.