Researchers studied surgeons' learning curve for minimally invasive lumbar laminectomy or laminotomy with or without discectomy, according to a study published in The Spine Journal.
The study included 228 consecutive patients undergoing a primary one- or two-level MIS LD by one surgeon for degenerative spinal pathology between 2009 and 2014. Between 2005 and 2006, 50 consecutive patients underwent one- or two-level open LD.
Researchers compared demographics, comorbidity, pain scores and outcomes between the first cohort of 50 MIS patients and the second cohort of 178 patients. They also compared the outcomes between the first 50 MIS and 50 open LD patients.
Here are six observations:
1. The initial 50 patients undergoing MIS LD experienced a greater procedural time and longer hospitalization stay, compared to the subsequent 178 patients undergoing MID LD.
2. The two cohorts did not demonstrate notable differences in estimated blood loss, pain scores, complication rates, recurrent herniation rates and reoperation rates.
3. The MIS patients experienced shorter procedural times, lower estimated blood loss and shorter hospital stays than the open LD patients.
4. The study revealed no difference between the MIS and open patients in terms of the reoperation rate and 30-day readmission rate.
5. The researchers found continued surgeon experience correlated with decreased operative time, shorter hospital stays and similar blood loss after MIS LD. Patients experienced similar clinical outcome improvements, independent of surgical experience, however.
6. The researchers concluded surgical experience may enhance perioperative parameters, but a surgeon with no prior experience may safely perform an MIS LD.