What is it about?
When back pain or leg pain related to disc herniations or arthritis in the back doesn't respond to rest, over the counter medications, and therapy; surgery can be incredibly effective in relieving the symptoms. However, some patients who have an operation on their back end up needing another operation in the coming years. Although this is frequently because a patient's arthritis continues to get worse over time (so it causes a new problem in the spine that needs another operation), it is possible that the technique used to perform the operation could be contributing to the need for more surgery. In "traditional" or "open" spine surgery, the muscle and ligaments that run along the spine and support the spine have to be removed in order to perform the operation. In minimally invasive spine surgery, these structures are left intact and the operation is performed through a small tube. This study shows that if a patient has a minimally invasive spine surgery instead of the traditional or open spine surgery, their chances of needing another operation on the spine is cut in half. This holds true whether a patient is having a small operation like a laminectomy or a discectomy or a bigger operation like a fusion.
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Why is it important?
Patients who need spine surgery frequently try to avoid it because of preconceived notions about needing more surgery down the road. So these patients frequently suffer with pain and limit their activities for many years instead of seeking the surgery they need. Being armed with this information, from a large study of over 2,000 patients followed for a minimum of five years, patients can be more confident knowing that if they choose a surgeon who performs minimally invasive spine surgery, that will decrease their risk of needing more surgery down the road.
Perspectives
As a neurosurgeon who has had the honor of operating on thousands of patients with lower back problems over the past dozen years, it is always disheartening to see patients avoid the care they need out of fear. I am always striving to figure out the best way to treat my patients, and nothing can help me do that with more confidence than having scientific data to guide my recommendations. These results verify my belief that minimally invasive spine surgery results in better long term outcomes by leaving the essential support structures (muscles and ligaments) of the spine intact. I hope this research gives patients confidence to get the care they need and helps them to choose a surgeon who can partner with them to decrease their chances of needing another operation on their spine many years later.
Dr. Daniel Fahim
Oakland University William Beaumont School of Medicine
Read the Original
This page is a summary of: Long-Term Reoperation Rates After Open versus Minimally Invasive Spine Surgery for Degenerative Lumbar Disease: Five Year Follow-Up of 2130 Patients, World Neurosurgery, March 2023, Elsevier,
DOI: 10.1016/j.wneu.2022.11.100.
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