On the surface, with results such as shorter hospital stays, less blood loss, and a lower chance of infection, it would seem that minimal access surgery would be more cost effective than an open spinal surgery. However, the instrumentation required for these techniques is often expensive and can outweigh the savings. A review of the literature comparing cost of minimal access surgery to open surgery found that there is no economic difference in the two techniques. However, several studies that suggested cost-saving with minimal access surgery were excluded from the review as they did not meet requirements of detailed methodology or long term follow up on clinical outcomes. There is a need for more detailed studies comparing cost-effectiveness of minimal access surgery to open conventional spine surgery in order to better understand the economic details of these surgical approaches.