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Comparison of Long-Term Follow-Up Outcomes Between Minimally Invasive and Open Surgery for Single-Level Lumbar
Tae Seok Jeong1, Seong Son, Sang Gu Lee
1Gil Medical Center, Gachon University College of Medicine, Department of Traumatology, Incheon, Korea.
Turkish Neurosurgery
|March 23, 2023
Summary
Minimally invasive surgery (MIS) and open surgery for single-level lumbar fusion show similar long-term clinical outcomes and complication rates after a decade. While MIS involves longer operative times, it results in less blood loss compared to open surgery.
Area of Science:
- Spine Surgery
- Orthopedics
- Neurosurgery
Background:
- Single-level lumbar fusion is a common procedure for spinal instability.
- Both open surgery and minimally invasive surgery (MIS) approaches are utilized.
- Long-term comparative outcomes between these techniques require extensive follow-up.
Purpose of the Study:
- To compare the long-term clinical outcomes of minimally invasive surgery (MIS) versus open surgery for single-level lumbar fusion.
- To evaluate differences in complications, radiographic findings, and patient-reported outcomes over a minimum 10-year follow-up period.
Main Methods:
- A cohort of 87 patients undergoing L4-L5 spinal fusion between 2004-2010 was retrospectively analyzed.
- Patients were divided into open surgery (n=44) and MIS (n=43) groups.
- Evaluated parameters included operative time, blood loss, complications, radiographic results, and patient-reported pain and disability scores.
Main Results:
- Mean follow-up exceeded 10 years for both groups.
- MIS group had longer operative times (4.37h vs 3.34h) but significantly less blood loss (281.40mL vs 440.23mL).
- No significant differences were observed in postoperative complications (infection, adjacent segment disease, pseudoarthrosis), radiographic findings, or patient-reported outcomes (pain, Oswestry Disability Index) between the groups at any time point.
Conclusions:
- Long-term follow-up (≥10 years) indicates no significant difference in clinical outcomes or complication rates between MIS and open single-level lumbar fusion.
- Both surgical approaches provide comparable long-term functional results and spinal stability.
- While MIS offers reduced blood loss, the choice between MIS and open surgery may depend on surgeon expertise and patient factors.
