Ayush Sharma
Consultant Orthopedic Spine Surgeon, Department of Orthopedic and Spine surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, India.
Title: Minimally invasive surgery for degenerative lumbar pathology an institutional experience
Biography:
Abstract:
Aim: Aim of the study was to compare the functional outcome of open vs minimally invasive surgery in degenerative lumbar pathology.
Material and methods: All patients undergoing surgery for degenerative lumbar pathology were prospectively followed for one year. VAS (Visual analogue score), ODI (Oswestry Disability Index) were used to analyse the functional outcome at post-operative period day one, two weeks, One month, three months, Six months and one year. Data was divided into open and minimally invasive group ( MIS) and analysed .P value <0.05 was taken as significant .
Result: 488 patients were included in the final analysis . 164 were from MIS group and 242 underwent open surgery . TLIF was done 142 patents of which 56 (39.4%) underwent MIS TLIF .240 patients were operated for discectomy . 104 (43.3%) were from MIS group and 136(56.6%) underwent open discectomy . While pre-operative mean VAS scores were comparable for both the groups . Follow up VAS scores were significantly better for MIS group at post-operative day one(P=0.001), two weeks(P=0.001),One month(P=0.001), three months(P=0.003) and Six months. (P=0.023) . Similarly ODI scores were also significantly better for MIS group at post-operative day one(P=0.004), two weeks(P=0.001) and one months(P=0.003). No significant difference was found between one year VAS scores between the two groups (P=0.145). . Similarly ODI scores were comparable between the two groups at three months, Six months and one year . Incidence of dural tear was slightly less (14.4%) in minimally invasive group compared to open surgery (16.13%) without any significant statistical difference(p=0.698). While two cases of dual tear from open group required revision exploration and re-suturing. No cases of CSF leak during MIS procedure required operative revision.
Conclusion: Functional outcome of minimally invasive surgery for degenerative lumbar pathology are comparable with open surgery with significantly improved VAS scores up to 6 months and significantly better ODI scores up to one month for the MIS group.