Abstract
The object of the study was to review the author's large series of minimally invasive spine surgeries for complication rates. The author reviewed a personal operative database for minimally access spine surgeries done through nonexpandable tubular retractors for extradural, nonfusion procedures. Consecutive cases (n = 1231) were reviewed for complications. There were no wound infections. Durotomy occurred in 33 cases (2.7% overall or 3.4% of lumbar cases). There were no external or symptomatic internal cerebrospinal fluid leaks or pseudomeningoceles requiring additional treatment. The only motor injuries were 3 C5 root palsies, 2 of which resolved. Minimally invasive spine surgery performed through tubular retractors can result in a low wound infection rate when compared to open surgery. Durotomy is no more common than open procedures and does not often result in the need for secondary procedures. New neurologic deficits are uncommon, with most observed at the C5 root. Minimally invasive spine surgery, even without benefits such as less pain or shorter hospital stays, can result in considerably lower complication rates than open surgery.
Highlights
Minimal access spinal surgery is a rapidly developing set of techniques, which have compared favorably with open surgeries in the recent literature [1,2,3,4]
In addition to reduced blood loss, shorter operative time, reduced postoperative pain, earlier discharge, rapid return to normal activities, and other reported advantages of minimally invasive surgery, [5] a decreased complication rate associated with these surgeries has been noted, with respect to wound infections [6]
There were no neurologic sequelae of this event, but the author began using the red rubber drain as noted above after this event. Another patient early in the series developed pain after a durotomy resulted in a nerve root herniation requiring reexploration from the contralateral side to reduce this
Summary
Minimal access spinal surgery is a rapidly developing set of techniques, which have compared favorably with open surgeries in the recent literature (see review in Wong et al, 2012) [1,2,3,4]. In addition to reduced blood loss, shorter operative time, reduced postoperative pain, earlier discharge, rapid return to normal activities, and other reported advantages of minimally invasive surgery, [5] a decreased complication rate associated with these surgeries has been noted, with respect to wound infections [6]. The author reports experience on management of a large series of minimally invasive spine procedures
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