"Minimally invasive" lumbar spine surgery: a critical review
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Michael Payer
- چاپ و سال / کشور: 2011
Description
Background Minimal-access technology has evolved rapidly with WtubularW or WpercutaneousW approaches for decompression and stabilization in the lumbar spine. Potential benefits (smaller scars, diminished local pain, reduced blood loss, reduced postoperative wound pain, shorter hospital stays) have to be weighed against possible drawbacks (reduced orientation, steep learning curve, increased radiation exposure, dependency on technology, cost). While non-comparative case series are often rather enthusiastic, comparative studies and particularly RCTs are scarce and might convey a more realistic appreciation. Methods A MEDLINE search via PubMed was performed to find all English-language studies comparing WopenW or WtraditionalW or WconventionalW with Wminimally invasiveW or WpercutaneousW or WtubularW approaches in degenerative lumbar spine surgery. Results Only nine comparative studies could be retrieved altogether. No clear benefit could be found for minimally invasive procedures in lumbar disc herniation, TLIF, or PLIF. There seems to be a slight advantage in terms of hardware safety in open procedures. Conclusions This review, based solely on the very limited number of available comparative studies, shows no relevant benefit from minimally invasive techniques, and a tendency for more safety in open procedures in lumbar disc herniation,TLIF and PLIF.
Acta Neurochir (2011) 153:1455–1459 DOI 10.1007/s00701-011-1023-4Received: 4 April 2011 / Accepted: 5 April 2011 / Published online: 1 May 2011 # Springer-Verlag 2011
