The validity of minimally invasive surgery in treatment of lumbar spine degenerative disease
1 Marko Lovrić
2 Ivana Ilić
1 Jerko Arambašić
1,2 Bojan Trogrlić
1,2 Dario Mužević
3 Bruno Splavski
1 Osijek University Hospital Center, Osijek, Croatia
2 Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
3 University of Applied Health Sciences, Zagreb, Croatia
Objectives: To compare patients with lumbar spine degenerative disease treated by minimally invasive surgery using tubular retractor system and conventional surgical method.
Study Design: Cross-sectional study with historical data.
Patients and Methods: The single-institution series included 48 adult patients treated with one of the two surgical methods during a one-year period. The patients were divided between a case group consisting of minimally invasively treated patients and a control group of those operated on by conventional surgery. The research data were the following: age, gender, duration of symptoms, type of spinal pathology, type of surgical method, number of surgical levels treated, neurological status, pain intensity assessed by Visual Analogue Scale, duration of surgery and length of hospital stay. Modified Odom’s criteria were used as a primary outcome measure. All data were documented from electronic medical records, statistically analyzed, and correlated between The validity of minimally invasive surgery in treatment of lumbar spine degenerative disease the groups. The level of statistical significance was set at p<0.001.
Results: A significant improvement of neurological status after surgery was recorded in all patients (case group, Fisher’s exact test, p=0.002, control group, Fisher’s exact test p=0.012). The pain intensity was significantly reduced after surgery in both groups (case group, Wilcoxon test, p<0.001, control group, Wilcoxon test, p<0.001). A statistically significant difference was observed between the case and the control group in the length of hospital stay (Mann-Whitney U test, p<0.001) and in time elapsed from surgery to patient mobilization (Mann-Whitney U test, p<0.001). In all other data examined, no statistically significant difference was noted between the case and control groups.
Conclusion: Surgical treatment of lumbar spine degenerative disease results in significant improvement of neurological status and in reduced pain intensity. Minimally invasive surgery using tubular retractors results in shorter length of stay and earlier patient mobilization.
Keywords: lumbar spine, degenerative disease, minimally invasive surgery, management outcome