Minimally invasive vs. open decompression for lumbar spinal stenosis: 5 key notes

Written by Laura Dyrda | June 08, 2017 | Print  |

The Congress of Neurological Surgeons named a paper authored by Roger Hartl, MD, as a top paper of the year.

Dr. Hartl and Karsten Sholler, MD, will present the paper at the 2017 CNS annual meeting in October. The paper, titled "Lumbar Spinal Stenosis Associated with Degenerative Lumbar Spondylolisthesis: A Systematic review and Meta-analysis of Secondary Fusion Rates Following Open vs. Minimally Invasive Decompression" received the 2017 Neurosurgery Top Spine & Peripheral Nerve Paper of the Year.

 

The paper authors analyzed 37 studies covering 1,156 patients and appeared in the March 2017 issue of Neurosurgery. The study authors found:

 

1. Most of the evidence was weak, at level III or IV.

 

2. The secondary fusion rates were 12.8 percent after open laminectomy and 3.3 percent after minimally invasive unilateral laminotomy. Total reoperations rates were 5.8 percent after the minimally invasive procedures and 16.3 percent after the open procedure.

 

3. Around three-quarters of the open studies reported a slip progression, compared to none of the minimally invasive studies.

 

4. The patient satisfaction scores were 62.7 percent for open procedures and 76 percent for the minimally invasive procedures.

 

5. The study authors concluded, "In patients with LSS and DS, minimally invasive decompression is associated with lower reoperation and fusion rates, less slip progression and greater patient satisfaction than open surgery."

 

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