1472. An Analysis of Peri-operative Complications Between Minimally Invasive Surgery as Compared with Open for Elective Degenerative Lumbar Disease

Authors: Marcelle Sofia Altshuler; Kyle Mueller, MD; Ashley MacConnell; Peter Wirth; Faheem Sandhu, MD, PhD; Jean-Marc Voyadzis (Washington, DC)

Introduction: Although traditional open surgery for decompression and fusion of lumbar pathology is efficacious, concerns exist regarding postoperative complications that may be mitigated by using minimally invasive surgery (MIS) techniques. Our aim was to evaluate peri-operative complications between patients that underwent MIS and conventional open techniques for degenerative lumbar pathology. Methods: A retrospective review of a prospectively collected database identified 1,435 patients that underwent surgery for degenerative lumbar pathology from January 2013-2016. We evaluated the rates of deep vein thrombosis, pulmonary embolism, urinary tract infection, pneumonia, pressure ulcer, blood transfusion, discharge to rehabilitation, and drain placement. Groups were analyzed based on decompression alone as compared with decompression and fusion for both MIS and traditional open techniques. Results: Patients that underwent traditional open lumbar decompression surgery were more likely to develop a DVT (p-value=0.007) and to have a drain placed (p-value<0.00001) than those undergoing MIS decompression. Patients that underwent traditional open lumbar fusion surgery compared to MIS fusion were also more likely to have a drain placed (p-value<0.0001) and require a blood transfusion (p-value=0.000239). Conclusion: Minimally invasive spinal surgery is comparable with traditional open spine surgery in terms of safety and efficacy in patients undergoing both lumbar spine decompression and fusion surgery. MIS techniques lead to improved complication rates including reduced rate of DVT for decompression and reduced transfusion rate for fusion. Randomized controlled trials are needed to better compare these two surgical techniques.