Minimally invasive versus open surgery for degenerative lumbar pathologies:a systematic review and meta-analysis

Abstract

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.

Robotic-navigated assistance in spine surgery

“…We found no difference in GRS grade between screws placed through Wiltse and open-midline incisions. However, according to previous published work, 14 the minimally invasive Wiltse approach is associated with significantly less blood loss (median 150.0 cc (IQR 100.0 to 250.0) vs 300.0 (IQR 150.0 to 440.0)) and a decreased length of hospital stay (3.0 days (IQR 2.0 to 5.0) vs 4.0 (IQR 3.0 to 5.75)), but with similar operating times, and may therefore be a valuable surgical option in RNA without compromising the accuracy of screw placement.…”

Bibliometric analysis of interspinous device in treatment of lumbar degenerative diseases

“…When conservative treatments, such as medication and physiotherapy, prove inadequate, surgical intervention is frequently necessary. [23] The lumbar non-fusion approach has given rise to the interspinous fixation system, which has become a widely utilized clinical option. This includes a variety of options such as static distraction systems (such as Wallis, X-STOP), dynamic stabilization systems (such as Coflex, DIAM, StenoFix), and innovative percutaneous implantable stability systems (such as Aperius, Superion, In-Space).…”

To assess the clinical effectiveness of unilateral biportal endoscopy (UBE) and uniportal endoscopy (UE) in the management of lumbar spinal stenosis.

“…Although it has a satisfactory clinical outcome when treating lumbar spinal stenosis, traditional open surgery can cause paravertebral muscle dissection, signi cant bleeding, and postoperative lumbar spine instability [3] . More research has demonstrated in recent years that uniportal endoscopy can treat lumbar spinal stenosis with clinical outcomes that are comparable to open surgery while requiring a smaller incision, less damage to the paravertebral muscle and spinal column bone structure, and a quicker recovery [4][5][6][7][8] .However, uniportal endoscopy (UE) has limits on surgical equipment, as the supporting surgical instruments are often small and the decompression time is prolonged. Currently, unilateral biportal endoscopy (UBE) technology is gaining popularity.…”