Minimally Invasive versus Open Posterior Lumbar Interbody Fusion: A Systematic Review

Abstract

BackgroundAlthough conventional open posterior lumbar interbody fusion (open PLIF) is efficacious in management of lumbar spinal instability, concerns exist regarding lengthy hospital stays, blood loss, and postoperative complications. Minimally invasive posterior lumbar interbody fusion (MIS PLIF) may be able to address these concerns, but the research on this topic has not been systematically reviewed. Questions/purposes We performed a systematic review to determine whether MIS PLIF or open PLIF results in (1) better perioperative parameters, including blood loss, operative times, and length of hospital stay; (2) improved patient-reported outcome scores; and (3) improved disc distraction and (4) frequency of reoperation and complications when compared with open PLIF procedures. Methods A literature search of the MEDLINE database identified seven studies that met our inclusion criteria. A total of seven articles were included; quality was assessed using the Methodological Index for Non-Randomised Studies (MINORS) scale. Descriptive statistics were used to describe the included articles.

Reoperation rate and risk factors of elective spinal surgery for degenerative spondylolisthesis: minimum 5-year follow-up

“…Additional studies in a prospective multicentered large population will be needed to further define the risk factor of reoperation of the surgical treatment of DS. Favorable clinical outcomes and reoperation rates for less-invasive decompression surgery for Meyerding Grade 1 DS were recently reported [22][23][24][25]; this less-invasive surgery might reduce the reoperation rate for decompression surgery for this condition.…”

The Outcomes of Minimally Invasive versus Open Posterior Approach Spinal Fusion in Treatment of Lumbar Spondylolisthesis: The Current Evidence from Prospective Comparative Studies

“…Currently, the minimally invasive (MI) lumbar spinal fusion techniques including MI posterior lumbar interbody fusion [6], MI transforaminal lumbar interbody fusion [7, 8], MI posterolateral lumbar fusion, MI lateral lumbar fusion [9], MI oblique lumbar interbody fusion, and MI anterior lumbar interbody fusion. The posterior approach permits the decompression and discectomy directly and does not have complications of vessel, hypogastric sympathetic plexus, and ureter injury, which may be caused by anterior approach [10–12], and is most widely used nowadays [13].…”

The Age Significance of Lumbar Disc Extrusion or Sequestration: A Systematic Review of the Literature

“…A more acceptable concept of minimal invasive surgery (MIS) could be observed without providing comprehensive information regarding the potential risks. Part of recent meta-analysis also concluded that better benefit could be obtained when performed in specialized centers by experienced surgeons [113] . A consensus of opinion in the literature concerning the growing number of lumbar spine surgeries would highlight the need for further improvement that would maximize clinical outcomes.…”