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Studies Needed for Minimally Invasive Decompression

Despite wide use, questions remain about its efficacy compared to traditional open techniques

FRIDAY, Aug. 8 (HealthDay News) -- Although direct decompression with minimally invasive surgery is widely used to treat lumbar disc herniation and lumbar stenosis, there is a lack of evidence to compare its effectiveness and possible superiority with traditional decompression, according to an article published in the August issue of Neurosurgical Focus.

Sean S. Armin, M.D., of the University of California Los Angeles, and colleagues reviewed several minimally invasive techniques, including chemonucleolysis, automated percutaneous lumbar discectomy, modified nucleotomy, and transforaminal endoscopic techniques.

Overall, the researchers state that these techniques appear to be inferior to the traditional gold standard microsurgical approach, pointing out that none of them can treat lateral recess or foraminal stenosis, hypertrophy of the ligamentum flavum, or osteophytes, which occur in lumbar stenosis.

"Although small non-randomized studiesÂ…do suggest a marginally smaller postoperative oral analgesic requirement and decreased length of hospital stay in the minimally invasive surgery direct decompression group, the actual efficacy and suspected superiority of the minimally invasive surgery technique compared to the traditional technique is still not well characterized," the authors conclude. "Future studies are still needed to determine the role of the minimally invasive surgery method in the treatment of lumbar stenosis and disc herniation."

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