Introduction
With the increase in life expectancy and consequent aging of the population, degenerative lumbar spine diseases tend to increase its number exponentially. Several treatment options are available to treat degenerative spinal diseases, such as laminectomies, posterior fusions, and interbody fusions, depending on their locations, correction necessities, and surgeon philosophy. With the advance in technology and surgical knowledge, minimally invasive techniques (MIS) arose as a solution to reduce surgical morbidity, while maintaining the same benefits as the traditionally/open surgeries. Several studies investigated the possible advantages of MIS techniques against the traditional open procedures. However, those articles are usually focused only on one technique or on one pathology.
Methods
The electronic databases, including PubMed, Google Scholar, Ovid, and BVS, were systematically reviewed. Only original articles in English or Portuguese were added to the review, the revision was performed following the PRISMA guideline.
Results
Fifty-three studies were included in the meta-analysis. Of the studied outcomes the Length of Stay Odds of complications, Blood Loss, and Surgery costs presented significantly favored MIS approaches, while the Last FUP ODI score, and Surgery Time did not differ among the groups.
Conclusion
Minimally invasive techniques are a remarkably interesting option to traditional open surgeries, as these procedures showed a significant reduction in blood loss, hospitalization time, complications, and surgical costs.
Introduction: Obesity is a global phenomenon that affects the quality of life of the population. In addition to being a factor that can lead to cases of degeneration in the spine, it can also influence the clinical outcomes of spine surgeries. However, with the development of minimally invasive techniques, the impact of obesity has become uncertain. Methods: A single-center, non-randomized, comparative, observational study, here clinical and surgical outcomes and postoperative complications were analyzed between obese and non-obese patients undergoing LLIF surgery. Results: There was no difference between surgical times and blood loss between the groups; the number of postoperative complications was similar. Both groups showed significant improvement in clinical parameters, but there was no difference between the amount of improvement between the obese and non-obese groups. Conclusion: The present study demonstrated that LLIF is a safe and effective technique regardless of the patient’s degree of obesity. Level of Evidence III; Retrospective study.
Resumo
Objetivos O presente estudo teve como objetivo avaliar se os parâmetros espinopélvicos pré-operatórios podem influenciar o ganho da lordose segmental após fusão intersomática lombar por via lateral de um nível.
Métodos Os seguintes parâmetros radiológicos foram medidos nos raios X: incidência pélvica, lordose lombar, versão pélvica, lordose L4S1, lordose segmental do nível operado, índice intraoperatório de lordose segmentar, mismatch pélvico (IP-LL), proporção de lordose distal, delta de lordose segmentar, PT > 20, inclinação sacral real e inclinação sacral ideal, e a correlação dessas variáveis com o ganho da lordose segmentar foi investigada. Posteriormente, foi realizada uma análise exploratória de cluster para identificar características comuns entre os pacientes e o ganho de lordose segmentar.
Resultados O presente estudo contou com 144 pacientes, dos quais 76% apresentaram ganho de lordose segmentar. Os parâmetros mais correlacionados com o ganho de lordose segmentar foram lordose segmentar pré-operatória (−0,50) e delta intraoperatório de lordose (0,51). Além disso, os pacientes dos grupos de incidência pélvica (IP) alto tiveram tendência de ganho de lordose segmental maior (p < 0,05) e redução do risco de perda de lordose segmental (chances 6.08).
Conclusão Pacientes com perfis de IP médios baixos apresentaram maiores chances de perda de lordose segmentar. No entanto, os parâmetros espinopélvicos pré-operatórios por si só não parecem desempenhar um papel significativo no destino do ganho da lordose segmentar.
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