Spinal surgeon delphi panel to gain consensus on minimally invasive surgery definitions for spinal fusion

BackgroundWhile there is a clear trend towards less invasive spinal procedures in recent years, determining what specifically constitutes minimally invasive surgery (MIS) for spinal fusion procedures can be challenging as published definitions are heterogeneous and address only select factors.PurposeTo utilize a Delphi Consensus Panel (DCP) process to build consensus among panelists regarding the definition of MIS for spinal fusion and define a consensus around best practices for adopting MIS technologies.MethodsDCP is a widely accepted method of qualitative data collection and analysis used for generating consensus from panel members. The DCP consisted of 2 online questionnaires completed by 11 expert panelists. Round 1 included 7 multiple choice demographics and 11 open-ended questions. Round 1 responses were analyzed to inform the development of statements for further assessment in Round 2. Round 2 included 93 closed-ended, 5-point Likert scale questions and 11 open-ended questions. Consensus was defined as agreement among at least 8 out of 11 panelists.ResultsConsensus was reached on 56 out of 93 statements regarding spinal fusion and/or fixation procedures. There was a high degree of consensus around the role of reduced tissue trauma, patient recovery time, hospital length of stay, and post-operative pain for MIS spinal fusion procedures compared to open procedures; and the value of various technologies in performing MIS spinal fusion procedures.ConclusionA consistent definition of what constitutes MIS for spinal fusion may help drive consistency across surgeons, facilities, and payers to define clinical and economic implications for these approaches.