Mini-open versus open decompression and fusion for lumbar degenerative spondylolisthesis with stenosis

The outcome of less invasive surgical techniques in comparison to traditional surgical techniques has been the source of debate. In this retrospective study, 51 patients who had undergone posterior lumbar fusion along with bilateral decompression were enrolled. Twenty-one patients underwent fusion using a standard, midline open technique (open group) and 30 patients underwent fusion using a mini-open technique, with a small, central incision for the decompression and bilateral paramedian incisions for the posterolateral fusion and placement of cannulated pedicle screws (mini-open group). Surgical variables were compared between the 2 groups. Patients in both groups experienced significant improvements in leg pain at 12 months, with a reduction in visual analog scale scores from 7.6 to 2.4 in the open group, and 7.8 to 2.3 in the mini-open group. There were no statistical differences between the groups in the magnitude of improvement of either the visual analog scale or Oswestry Disability Index scores. Operative times, blood loss, and length of hospitalization failed to show statistically significant differences between the groups, although there was a trend toward less blood loss and shorter hospitalization in the mini-open group. Fusion results and complications were similar between the 2 groups. Both techniques resulted in similarly statistically significant improvements in pain and clinical function.