Comparison of percutaneous minimally invasive versus open posterior spine surgery for fixation of thoracolumbar fractures: A retrospective matched cohort analysis

Afolabi, Abimbola; Weir, Tristan; Usmani, M. Farooq; Camacho, Jael E; Bruckner, Jacob J; Gopinath, Rohan; Banagan, Kelley; Koh, Eugene Y.; Gelb, Daniel E.; Ludwig, Steven C.

doi:10.1016/j.jor.2019.11.047

Cited by 14 publications

(17 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We identified 10 articles comparing open and MIS approaches for treating spinal trauma/fractures. Seven of these studies found that MIS was significantly favorable with respect to operative time, [30][31][32][33][34][35][36] and the remaining 3 studies [37][38][39] found no significant difference between MIS and open surgical approaches. Eight studies evaluated intraoperative blood loss, and all 8 studies found that MIS techniques resulted in significantly less blood loss.…”

Section: Trauma/fracturementioning

confidence: 99%

“…Eight studies evaluated intraoperative blood loss, and all 8 studies found that MIS techniques resulted in significantly less blood loss. 32,[34][35][36][37][38][39][40] Of the 6 studies that reported results on LOS, 3 studies found MIS to be the favorable technique 30,31,36 and 3 studies did not find any significant differences 32,34,37 between MIS and open. Only one Chinese group reported data on costs.…”

Section: Trauma/fracturementioning

confidence: 99%

See 1 more Smart Citation

Is Less Really More? Economic Evaluation of Minimally Invasive Surgery

Chung

Ballatori

Ortega

et al. 2020

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Review. Objective: A comparative overview of cost-effectiveness between minimally invasive versus and equivalent open spinal surgeries. Methods: A literature search using PubMed was performed to identify articles of interest. To maximize the capture of studies in our initial search, we combined variants of the terms “cost,” “minimally invasive,” “spine,” “spinal fusion,” “decompression” as either keywords or MeSH terms. PearlDiver database was queried for open and minimally invasive surgery (MIS; endoscopic or percutaneous) reimbursements between Q3 2015 and Q2 2018. Results: In general, MIS techniques appeared to decrease blood loss, shorten hospital lengths of stay, mitigate complications, decrease perioperative pain, and enable quicker return to daily activities when compared to equivalent open surgical techniques. With regard to cost, primarily as a result of these latter benefits, MIS was associated with lower costs of care when compared to equivalent open techniques. However, cost reporting was sparse, and relevant methodology was inconsistent throughout the spine literature. Within the PearlDiver data sets, MIS approaches had lower reimbursements than open approaches for both lumbar posterior fusion and discectomy. Conclusions: Current data suggests that overall cost-savings may be incurred with use of MIS techniques. However, data reporting on costs lacks in uniformity, making it difficult to formulate any firm conclusions regarding any incremental improvements in cost-effectiveness that may be incurred when utilizing MIS techniques when compared to equivalent open techniques.

show abstract

Section: Trauma/fracturementioning

confidence: 99%

Section: Trauma/fracturementioning

confidence: 99%

Is Less Really More? Economic Evaluation of Minimally Invasive Surgery

Chung

Ballatori

Ortega

et al. 2020

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…In the spine, the indications for MISS are mainly herniated intervertebral disc [1][2][3][4][5][6]. Compared to the traditional open spine surgery MISS has many advantages in the perioperative period, such as minimal tissue trauma, reduced blood loss, decreased postoperative pain, and a diminished need for deep anesthesia [5][6][7][8]. Many patients experience a much shorter length of inpatient stay.…”

Section: Surgical Management Has Traditionally Been Accomplishedmentioning

confidence: 99%

“…1,2). The inclusion and exclusion criteria for this study have been published elsewhere in detail and are briefly described in the following [8,11].…”

Section: Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Anesthesia For Endoscopic Spine Surgery Of The Spine In An Ambulatory Surgery Center

Abrão¹,

Dowling

León

et al. 2020

GJAPM

View full text Add to dashboard Cite

Background: Providing adequate anesthesia that caters to rapid turn-over in an outpatient ambulatory surgery center setting is sometimes as much of an art as it is a science. Outpatient spine surgery is characterized by shorter simplified versions of their inpatient counterparts carried out in a hospital setting. Objective:The monitored anesthesia care (MAC) and deep sedation with a laryngeal mask airway (LMA) in the prone position have received little attention in the anesthesia and spine surgery literature. The authors reviewed their clinical outcomes with the outpatient endoscopic spinal surgery in conjunction with these two types of anesthesias. Methods:We performed an analysis of perioperative anesthesia and clinical outcomes in 184 patients who underwent lumbar endoscopic spinal surgery in two outpatient ambulatory surgery centers. The 184 patients consisted of 90 (48.9%) women and 94 (51.1%) men with an average age of 54.3 ± 15.4 years. The average follow-up of 43.27 months. The primary clinical outcome measures were the modified Macnab criteria. Chi-square testing was employed to analyze statistically significant associations between the type of anesthesia, preoperative diagnosis, the surgical level(s), and surgeon requirements for MAC versus balanced general anesthesia.Results: At the final follow-up, the majority of patients had Excellent (93/184; 50.5%) and Good (74/184; 40.2%) Macnab outcomes regardless of treatment and anesthesia. There was minimal blood loss in all patients, and there were no complications such as dural tears, or hematomas. There were also no wound problems such as bleeding, or leaking of endoscopic irrigation fluid from the wound. Of the 184 study patients, 40 patients (21.7%) had a postoperative irritation of the dorsal root ganglion (DRG). The mean anesthesia time was 37 ± 9 minutes in patients under balanced general anesthesia. with LMA and 48 ± 12 minutes in MAC patients. All of the 184 patients were discharged under one hour from the PACU after an uneventful wakeup. Only six patients (3.26%) had postoperative nausea.Conclusions: Monitored anesthesia care with sedation in an ambulatory surgery center in the prone position is best suited for endoscopic spinal decompressions. Intubation of the patient with general anesthesia is generally not required. Most patients can be managed with a nasal cannula, face mask, or a balanced general anesthesia with a laryngeal mask airway (LMA).

show abstract