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Less Invasive Back Surgery Offers Advantages

Patients show improved scores and shorter hospitalization after limited exposure fusion

WEDNESDAY, April 1 (HealthDay News) -- A less-invasive posterior lumbar interbody fusion appears to provide improved outcomes compared to the standard version of the surgery, according to research published in the March 15 issue of Spine.

Ata G. Kasis, M.D., of the University Hospital of North Tees in Stockton, U.K., and colleagues analyzed data from 114 patients who underwent standard posterior lumbar interbody fusion (ST-PLIF) and 209 who underwent limited exposure PLIF with total facetectomy (LI-PLIF) for degenerative lumbar disc disease. The LI-PLIF preserves posterior elements, includes bilateral total facetectomy, and doesn't require iliac crest bone harvesting.

Though both groups showed improved clinical outcomes, the LI-PLIF group showed greater improvement in Oswestry Disability Index score, visual analog scores for back and leg pain, and short-form 36 score for bodily pain. Patients had a shorter hospital stay after LI-PLIF and a lower occurrence of operative complications, the investigators found.

"Significantly shortened hospital stay with LI-PLIF probably reflected the less invasive technique per se. Significantly better clinical outcomes and fewer complications with LI-PLIF, however, potentially reflected maneuvers singular to LI-PLIF: (1) preservation of posterior elements, (2) avoidance of far lateral dissection over the transverse processes, (3) bilateral total facetectomy, (4) fewer neurologic complications, and (5) avoidance of iliac crest autograft. We therefore recommend LI-PLIF over ST-PLIF," the authors conclude.

A study co-author developed the LI-PLIF technique.

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