December 23, 2014 9:18 — 4 Comments
Study: Outcomes the Same Between Minimally Invasive, Open Disc Surgery
Researchers have found that current evidence does not support the routine use of minimally invasive surgery to remove herniated disc material pressing on the nerve root or spinal cord in the neck or lower back. In comparing it with open surgery, they found that while minimally invasive surgery for cervical or lumbar discectomy may speed up recovery and reduce post-operative pain, it does not improve long-term function or reduce long-term extremity pain. The researchers concluded that outcomes between minimally invasive and open discectomies were essentially the same, they reported. The study was recently published in the journal CMAJ Open. The researchers performed a meta-analysis of previous studies to examine the effects of minimally invasive versus open surgery on functional outcomes, pain, complications and reoperations among patients undergoing cervical or lumbar discectomy. They searched the MEDLINE, Embase and Cochrane Library databases for reports of relevant randomized controlled trials and reviewed four trials involving 431 patients in the cervical discectomy group, and 10 trials involving 1,159 patients in the lumbar discectomy group. “Many spinal surgery procedures are known to have difficult learning curves, and surgeons embarking on minimally invasive surgical techniques should obtain specialized training to minimize complications,” the authors wrote. “Conventional open techniques for spinal surgery are themselves technically demanding, and minimally invasive techniques are likely even more challenging.” To learn more about this study, click here.
we should consider spinal instability as a failure cause in using minimally invasive techniques , also long term problems of open surgery is threatening the spinal instability
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I think it’s great news that the long term results are the same. The real point though is that “minimally invasive surgery for cervical or lumbar discectomy may speed up recovery and reduce post-operative pain…” That’s the sole reason for doing it that way, and the fact that the long term results are the same once the patient has recovered from the surgery that is easier to do after minimally invasive intervention is the whole point and attests to the validity of the technique.
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I agree with Larry Hartman, the whole idea is to help the patient recover faster and with less pain. These factors are extremely valuable in patient centred care. Besides lack of expertise, could anyone justify the additional pain and longer recovery to the patient during the informed consent by simply stating that the long-term outcome is equivocal?
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done properly, micodiscectomy (even loupes and headlight) can be done in ASC and patient is out to lunch before surgeon. “minimally invasive” just another marketing gimmick. the avascular subperiosteal plane less traumatic than boring a hole through the muscles. industry and md developers driving this trend. benefit for some multilevel or deformity procedures, but micro disc? please, people, if no one else will say it, i will. the emperor has no clothes
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