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J Spinal Disord Tech. 2012 Feb;25(1):47-51. doi: 10.1097/BSD.0b013e31820baa1e.

Minimally invasive lumbar decompression: long-term outcome, morbidity, and the learning curve from the first 50 cases.

Author information

1
Department of Neurosurgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia. richard.mannion@nhs.net

Abstract

STUDY DESIGN:

Prospective observational study.

OBJECTIVE:

To describe our experience with the first 50 cases of minimally invasive lumbar canal decompression in terms of patient outcome up to 2 years, the learning curve incurred, and complications when compared with our most recent 50 cases.

SUMMARY OF BACKGROUND DATA:

Lumbar canal stenosis is a common condition in the elderly population, the symptoms of which respond well to surgical decompression. A minimally invasive approach offers potential short and long-term benefits to patients but the technique is associated with a learning curve and equivalence to open surgery regarding efficacy and complications needs to be demonstrated.

METHODS:

Fifty patients (mean age 70 y) who presented with clinical and radiological features of lumbar canal stenosis and who had failed a period of conservative management underwent lumbar canal decompression through a paramedian oblique, muscle splitting approach using a 16 to 18 mm operating tube and microscope. Outcome was assessed using the Oswestry Disability Index and Short Form-36 at 3 months, 1 year, and 2 years.

RESULTS:

Significant clinical improvements were seen at 3 months that were sustained at 1 and 2 years. Clinical outcome improved whereas operative time and complications fell as experience increased, helping to define the learning curve with this technique.

CONCLUSIONS:

Minimally invasive lumbar decompression seems to offer patients a clinical benefit comparable to that observed in published open series, with potential advantages in terms of postoperative pain and recovery. However, there is a learning curve and whether this technique offers long-term benefits with regard to a reduction in back pain or postoperative spondylolisthesis is not yet known.

PMID:
21577160
DOI:
10.1097/BSD.0b013e31820baa1e
[Indexed for MEDLINE]
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