5 key notes on MIS vs. open technologies for lumbar spinal fusion


A new study published in The Spine Journal examines minimally invasive spinal fusion technologies and whether they lead to a better outcome after elective interbody fusion.

The study authors collected data from the National Neurosurgery Quality and Outcomes Database examining patients who underwent one- or two-level interbody lumbar fusion for spinal stenosis or grade I spondylolisthesis. The patients either received MIS or open procedures. There were 467 patients who underwent the procedure with MIS technologies and 1,480 who underwent open surgery.


The researchers found:


1. The MIS patients were slightly healthier and more likely to have private insurance than those who underwent open procedures. The MIS patients were also less likely to undergo two-level procedures.


2. The MIS cohort was associated with less blood loss, more than half a day shorter stay at the hospital and 5 percent reduction in post-discharge inpatient rehabilitation when unmatched with the open procedure patients. The MIS patients also reported equivalent 90-day safety measures to the open procedure patients.


3. The MIS patients were still associated with lower blood loss and shorter length of stay after one-level procedures after propensity matching. The MIS patients who underwent two-level procedures reported similar lengths of stay to the open procedure patients.


4. The patient outcomes in 90-day safety measures were similar and the MIS technologies were associated with equivalent return to work than the open procedure technologies.


5. MIS patients were associated with equivalent patient reported pain, physical disability and quality of life through the one-year follow up.


"While MIS enabling technologies may increase some in-hospital care efficiencies, MIS clinical outcomes are similar to open surgery for patients undergoing one- and two-level interbody lumbar fusions," concluded the study authors.


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