HealthDay News — Minimally invasive surgery for spinal lumbar interbody fusion is associated with less blood loss and shorter hospital stays compared with open surgery, although these advantages disappear when a concomitant decompression is necessary, study findings show.

Christopher K. Kepler, MD, MBA, from the Department of Orthopaedic Surgery at Thomas Jefferson University in Philadelphia, and colleagues retrospectively compared outcomes for 81 patients who underwent a combined open anterior lumbar interbody fusion and minimally invasive posterior lumbar fusion using a cannulated pedicle screw system with 81 patients who underwent combined open anterior lumbar interbody fusion and traditional open pedicle screw instrumentation.

Minimally invasive surgery was associated with less blood loss, less need for transfusions, and shorter hospital stays, Kepler and colleagues reported in the Spine Journal.

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But these apparent advantages disappeared if concomitant posterior decompression was performed. Minimally invasive surgery also exposed staff to greater radiation from intraoperative imaging. The two patient groups were similar in terms of the rate of infection and major complications.

“These data support the notion that minimally invasive surgery has reduced operative morbidity and faster early recovery when used for posterior instrumentation but may not have significant benefits when a concomitant decompression is necessary,” Kepler and colleagues conclude. “It should be acknowledged that the benefits to minimally invasive surgery come at the cost of significantly higher use of ionizing radiation.”


  1. Kepler CK et al. Spine J. 2013; 13(5):489-497.