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IP Indian Journal of Neurosciences


Minimally invasive spine surgery: An alternate corridor for various spinal procedures – Our institute experience


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Author Details: Bijukrishnan R,Shaji U. A,Sreenath K*

Volume : 4

Issue : 4

Online ISSN : 2581-916X

Print ISSN : 2581-8236

Article First Page : 197

Article End Page : 203


Abstract

Introduction: Minimally invasive spine procedures are minimally destructive procedures which minimizes surgery related morbidity by avoiding excessive muscle dissection and reduce tissue trauma during surgery. The indications of these procedures are increased significantly these days.
Aim: To report our experience with minimally invasive spine surgery for various spinal procedures.

Materials and Methods: This is an observational study done from 2016 to 2018, in the department of Neurosurgery, Government medical college, Thrissur. We randomly selected 35 patients, who underwent various minimally invasive spine procedures, which include 15 lumbar discectomy (9 L5S1, 5 L45, 1 L34), 10 pedicle screw fixation (both dorsal and lumbar) and 10 IDEM spinal tumours.
Results: Mean age of patients was 45.72 years. Most of them were in between 20 to 60 years of age with 20 males (57.14%) and 15 females (42.85%). Mean blood loss was 105 ml for discectomy, 125 ml for pedicle screw fixation and 154 ml for IDEM tumour excision and no patient required blood transfusion. Average duration of procedure was 95 minutes for disc prolapse, 150 minutes for fracture fixation and 190 minutes for spine tumour excision. Average number of shots of C arm exposure was 6 for IVDP, 38 for fracture fixation and 6 for spine tumour excision. All Junior neurosurgeons of our department performed at least one discectomy or pedicle screw fixation without much difference in duration or outcome but surgeons with enough experience in open spinal procedures or spine tumour excision were required for all spine tumour excision cases. Improved pain score was noted during post operative period. Two patients developed CSF leak and mild postoperative wound infection which was managed conservatively. No patient developed new onset neurological deficits, bowel or bladder involvement in the post operative period.
Conclusions: We observed that minimally invasive spine surgery is safe and less destructive. The procedure is fast and associated with minimal morbidity and no mortality. We also noticed that there is increased risk for radiation associated with minimally invasive pedicle screw fixation. There is no significant learning curve associated with pedicle screw fixation or lumbar discectomy but it is significant in case of minimally invasive spine tumour excision.

Keywords: Minimally invasive, Spine surgery, Tubular retractor.

Doi :-https://doi.org/10.18231/2455-8451.2018.0046