1617. Low Perioperative Complications and Good Short-Term Outcomes After Revision Spine Surgery Using Minimally Invasive (MIS) Techniques

Authors: Andre Samuel; Avani Vaishnav, MBBS; Steven McAnany, MD; Todd Albert, MD; Sravisht Iyer, MD; Catherine Himo Gang, MPH; Sheeraz Qureshi, MD, MBA (New York, NY)

Introduction:

Minimally invasive (MIS) techniques have been shown to reduce morbidity and improve recovery after spine surgery and are increasingly used for revision cases.

Methods:

A retrospective review was conducted of all cases of MIS revision lumbar spine surgery by a single surgeon. Patients were grouped into 3 cohorts: revision decompression/discectomy after previous decompression/discectomy (cohort DD), primary fusion after previous decompression/discectomy (cohort PF), and revision of prior spinal fusion (cohort RF). Patient characteristics, surgical data, and short-term postoperative outcomes were collected and compared.

Results:

A total of 58 patients undergoing MIS revision lumbar spine surgery were identified, including 21 in cohort DD, 22 in cohort PF, and 15 in cohort RF. The most common preoperative diagnoses were recurrent herniated nucleus pulposus in cohort DD, recurrent same segment stenosis in cohort PF, and pseudoarthrosis in Cohort RF (Table 1). Mean operative time was 46.4±6.3, 110.8±11.9, and 96.2±13.4 minutes in cohort DD, PF, and RF respectively (P < 0.01). Estimated blood loss , postoperative pain and opiate use was low and not significantly difference in all three cohorts (Table 2, P  > 0.05). There were no cases of neurological injuries, incidental durotomies, or surgical site infections. There was a statistically significant improvement in ODI in cohort DD by 2-week follow up (Table 3, 43.3±4.2 to 23.4±4.1, P < 0.05) which was maintained through 12-week follow up (P < 0.05). There was a significant improvement in ODI by 12-week follow up in cohort PF (46.3±4.6 to 36.4±5.1, P < 0.05) and cohort RF (46.2±6.2 to 28.0±6.0, P < 0.05).

Conclusion:

Using MIS techniques in revision lumbar spine surgery results in low perioperative morbidity, complications, and postoperative pain. Patients also report good short term functional improvement after surgery.