A new study published in Spine examines the effectiveness and economics of open and minimally invasive posterior or transforaminal lumbar interbody fusion.
The study authors examined Medline, EMBASE, Web of Science and Cochrane from database inception to September 2015. The studies compared minimally invasive to open TLIF or PLIF for degenerative lumbar conditions. The studies had at least 10 patients in each arm. There were 45 studies that met inclusion with 3,472 patients undergoing minimally invasive fusion and 5,925 with open procedures.
The researchers found:
1. There wasn’t a significant difference in operative time between the two groups.
2. Patients in the minimally invasive fusion group had less blood loss than the open procedure group.
3. Patients in the open spine surgery group had longer hospital stays than the patients in the minimally invasive surgery group.
4. There wasn’t a difference between the two techniques for VAS, ODI, SF-36, SF-12 or EQ-5D scores for the 12 months to 60 months follow-up.
5. The complication and fusion rates were equivalent between the two groups.
6. The economic studies show a cost savings for the minimally invasive fusion patients ranging from 2.5 percent to 49.3 percent.