Geriatric spinal disorders, such as degenerative lumbar spinal stenosis, lumbar disc herniation, and osteoporotic vertebral compression fracture, have emerged as one of the primary orthopedic diseases impairing the quality of life among the elderly. Elderly patients are frequently complicated with underlying diseases of multiple system, including hypertension, diabetes mellitus, and cardiopulmonary insufficiency, along with physiological degeneration such as osteoporosis and sarcopenia. Traditional open spine surgery is characterized by large trauma, excessive bleeding, delayed postoperative recovery, and a relatively high incidence rate of complications, which renders it inadequate to address the treatment demands for elderly patients. In recent years, minimally invasive spinal surgery has become an important therapeutic approach of elderly spinal diseases due to its advantages of less trauma, less intraoperative interference and rapid postoperative recovery. Based on the domestic and foreign research in recent years, this paper systematically reviews the mainstream surgical methods and key technical breakthroughs of minimally invasive spinal surgery in the elderly, analyzes the current challenges, and looks forward to the future development direction, so as to provide clinical reference and research ideas for minimally invasive treatment of spinal diseases in the elderly.

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