Does minimally invasive spine surgery reduce the rate of perioperative medical complications? A retrospective single-center experience of 1435 degenerative lumbar spine surgeries

Abstract

Purpose

It is unclear if minimally invasive techniques reduce the rate of perioperative complications when compared to traditional open approaches to the lumbar spine. Our aim was to evaluate perioperative complications in patients that underwent MIS and conventional open techniques for degenerative lumbar pathology.

Methods

A retrospective review of a prospectively collected database identified 1435 patients that underwent surgery for degenerative lumbar pathology from January 2013–2016. We evaluated the rates of deep vein thrombosis, pulmonary embolism, urinary tract infection, and pneumonia. Groups were analyzed based on decompression alone as compared with decompression and fusion for both MIS and traditional open techniques.

Results

Patients that underwent traditional open lumbar decompression surgery were more likely to develop a DVT (P = .01) than those undergoing MIS decompression. There was no significant difference in rates of PE (P = .99), UTI (P = .24), or pneumonia (P = .56). Patients that underwent traditional open lumbar fusion surgery compared to MIS fusion were also more likely to have a PE (P = .03). There was no significant difference in rates of DVT (P = .22), UTI (P = .43), or pneumonia (P = .24).

Conclusion

Minimally invasive spinal surgery was found to reduce the rate of DVT for decompression surgeries and reduce the rate of PE for fusion surgeries.

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References

  1. 1.

    Karikari I, Isaacs R (2010) Minimally invasive transforaminal lumbar interbody fusion: a review of techniques and out comes. Spine 35:S294–S301

    Article  Google Scholar 

  2. 2.

    Wu R, Fraser J, Hartl R (2010) Minimal access versus open transforaminal lumbar interbody fusion: meta-analysis of fusion rates. Spine 35:2273–2281

    Article  Google Scholar 

  3. 3.

    Foley K, Holly L, Schwender J (2003) Minimally invasive lumbar fusion. Spine 28:S26–S35

    PubMed  Google Scholar 

  4. 4.

    Min S, Kim M, Seo J, Lee J, Lee D (2009) The quantitative analysis of back muscle degeneration after posterior lumbar fusion: comparison of minimally invasive and conventional open surgery. Asian Spine J 3:89–95

    Article  Google Scholar 

  5. 5.

    Xie L, Wu W, Liang Y (2016) Comparison between minimally invasive transforaminal lumbar interbody fusion and conventional open transforaminal lumbar interbody fusion: an updated meta-analysis. Chin Med J (Engl) 129:1969–1986

    Article  Google Scholar 

  6. 6.

    Chang X, Chen B, Li H, Han X, Zhou Y, Li C (2014) The safety and efficacy of minimally invasive discectomy: a meta-analysis of prospective randomised controlled trials. Int Orthop 38(6):1225–1234

    Article  Google Scholar 

  7. 7.

    Parker SL, Mendenhall SK, Shau DN, Zuckerman SL, Godil SS, Cheng JS, McGirt MJ (2014) Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis: comparative effectiveness and cost-utility analysis. World Neurosurg 82(1–2):230–238

    Article  Google Scholar 

  8. 8.

    Adogwa O, Parker S, Bydon A, Cheng J, McGirt M (2011) Comparative effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion: 2-year assessment of narcotic use, return to work, disability, and quality of life. J Spinal Disord Tech 24:479–484

    PubMed  Google Scholar 

  9. 9.

    Tian N, Wu Y, Zhang X, Xu H, Chi Y, Mao F (2013) Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence. Eur Spine J 22:1741–1749

    Article  Google Scholar 

  10. 10.

    Sun Z, Li W, Zhao Y, Qiu G (2013) Comparing minimally invasive and open transforaminal lumbar interbody fusion for treatment of degenerative lumbar disease: a meta-analysis. Chin Med J 126:3962–3971

    PubMed  Google Scholar 

  11. 11.

    Mueller K, Zhao D, Johnson O, Sandhu F, Voyadzis J (2019) The difference in surgical site infection rates between open and minimally invasive spine surgery for degenerative lumbar pathology: a retrospective single center experience of 1,442 cases. Oper Neurosurg 16(6):750–755

    Article  Google Scholar 

  12. 12.

    Wang TY, Sakamoto JT, Nayar G, Suresh V, Loriaux DB, Desai R, Martin JR, Adogwa O, Moreno J, Bagley CA, Karikari IO, Gottfried ON (2015) Independent predictors of 30-day perioperative deep vein thrombosis in 1346 consecutive patients after spine surgery. World Neurosurg 84(6):1605–1612

    Article  Google Scholar 

  13. 13.

    Horn SR, Liu TC, Horowitz JA, Oh C, Bortz CA, Segreto FA et al (2018) Clinical impact and economic burden of hospital-acquired conditions following common surgical procedures. Spine 43(22):E1358–E1363

    Article  Google Scholar 

  14. 14.

    Tominaga H, Setoguchi T, Tanabe F, Kawamura I, Tsuneyoshi Y, Kawabata N, Nagano S, Abematsu M, Yamamoto T, Yone K, Komiya S (2015) Risk factors for venous thromboembolism after spine surgery. Medicine 94(5):e466

    Article  Google Scholar 

  15. 15.

    Ikeda T, Miyamoto H, Hashimoto K, Akagi M (2017) Predictable factors of deep venous thrombosis in patients undergoing spine surgery. J Orthop Sci 22(2):197–200

    Article  Google Scholar 

  16. 16.

    Cloney MB, Hopkins B, Dhillon ES, Dahdaleh NS (2018) The timing of venous thromboembolic events after spine surgery: a single-center experience with 6869 consecutive patients. J Neurosurg Spine 28(1):88–95

    Article  Google Scholar 

  17. 17.

    Yamasaki K, Hoshino M, Omori K, Igarashi H, Tsuruta T, Miyakata H, Nemoto Y, Matsuzaki H, Iriuchishima T (2017) Prevalence and risk factors of deep vein thrombosis in patients undergoing lumbar spine surgery. J Orthop Sci 22(6):1021–1025

    Article  Google Scholar 

  18. 18.

    Kim HJ, Walcott-Sapp S, Adler RS, Pavlov H, Boachie-Adjei O, Westrich GH (2011) Thromboembolic complications following spine surgery assessed with spiral CT scans: DVT/PE following spine surgery. HSS J 7(1):37–40

    Article  Google Scholar 

  19. 19.

    Piper K, Algattas H, DeAndrea-Lazarus IA, Kimmell KT, Li YM, Walter KA, Silberstein HJ, Vates GE (2017) Risk factors associated with venous thromboembolism in patients undergoing spine surgery. J Neurosurg Spine 26(1):90–96

    Article  Google Scholar 

  20. 20.

    Altschul D, Kobets A, Nakhla J, Jada A, Nasser R, Kinon MD et al (2017) Postoperative urinary retention in patients undergoing elective spinal surgery. J Neurosurg Spine 26:229–234

    Article  Google Scholar 

  21. 21.

    Golubovsky JL, Ilyas H, Chen J, Tanenbaum JE, Mroz TE, Steinmetz MP (2018) Risk factors and associated complications for postoperative urinary retention after lumbar surgery for lumbar spinal stenosis. Spine J 18(9):1533–1539

    Article  Google Scholar 

  22. 22.

    Tominaga H, Setoguchi T, Ishidou Y, Nagano S, Yamamoto T, Komiya S (2016) Risk factors for surgical site infection and urinary tract infection after spine surgery. Eur Spine J 25(12):3908–3915

    Article  Google Scholar 

  23. 23.

    Chughtai M, Gwam CU, Khlopas A, Newman JM, Curtis GL, Torres PA, Khan R, Mont MA (2017) The incidence of postoperative pneumonia in various surgical subspecialties: a dual database analysis. Surg Technol Int 30:45–51

    PubMed  Google Scholar 

  24. 24.

    Chughtai M, Gwam CU, Mohamed N, Khlopas A, Newman JM, Khan R, Nadhim A, Shaffiy S, Mont MA (2017) The epidemiology and risk factors for postoperative pneumonia. J Clin Med Res 9(6):466–475

    Article  Google Scholar 

  25. 25.

    Fan S, Zhao X, Zhao F, Fang X (2010) Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases. Spine 35:1615–1620

    Article  Google Scholar 

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Correspondence to Jean-Marc Voyadzis.

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Altshuler, M., Mueller, K., MacConnell, A. et al. Does minimally invasive spine surgery reduce the rate of perioperative medical complications? A retrospective single-center experience of 1435 degenerative lumbar spine surgeries. Eur Spine J 30, 122–127 (2021). https://doi.org/10.1007/s00586-020-06536-y

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Keywords

  • Complication rate
  • Minimally invasive surgery
  • Perioperative complication rate
  • Degenerative lumbar disease
  • Venous thrombosis complication