Minimally Invasive Lumbar Fusion Is Associated with Lower Reoperation for Adjacent Segment Disease and Improved Patient-Reported Outcomes Compared with Open Surgery.

Centofanti E, Liesching M, Estafanous B, Christopher SR, Ghogawala Z, Magge SN, Whitmore RG.

Journal ArticleAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

In a 419-patient study, minimally invasive lumbar fusion was associated with a significantly lower rate of reoperation for adjacent segment disease and better patient-reported quality-of-life and disability outcomes at 2 years compared with open surgery.

What was studied

A retrospective single-institution study of 419 patients who underwent 1- or 2-level lumbar fusion (November 2013-April 2024), comparing open spinal fusion (n=259) with minimally invasive surgery (MIS) lumbar fusion (n=160), with reoperation for adjacent segment disease (ASD) as the primary outcome and complications and patient-reported outcomes (EQ-5D, Oswestry Disability Index) at 2 years as secondary outcomes in a subset of 108 patients with available data.

Key findings

The overall rate of reoperation for adjacent segment disease was significantly higher in the open surgery group than the MIS group (19% vs 9%, p = 0.003).
In the subset of 108 patients with 2-year patient-reported outcome data, MIS surgery showed significantly better EQ-5D scores (0.86 vs 0.75, p = 0.01) and Oswestry Disability Index scores (13 vs 25, p = 0.002) compared with open surgery.
Mean follow-up was similar between groups (34 months for open, 32 months for MIS).

Clinical relevance

The findings suggest that minimally invasive lumbar fusion may reduce the risk of needing reoperation for adjacent segment disease and improve longer-term quality of life and disability outcomes compared with open surgery, which could inform surgical approach selection for appropriate candidates.

Who should care

Neurosurgery

Limitations

This was a retrospective, non-randomized, single-institution comparison, and the 2-year patient-reported outcome analysis was based on a smaller subset (108 of 419) of patients with available follow-up data, which may introduce selection bias.

Minimally invasive lumbar fusion was associated with a lower rate of reoperation for adjacent segment disease and better 2-year patient-reported outcomes than open surgery in this 419-patient study.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Objective

Adjacent segment disease (ASD) is characterized by symptomatic degenerative changes at the level above or below an index spinal fusion. As minimally invasive surgical (MIS) approaches might be less traumatic to adjacent facet joints, we hypothesized that MIS approaches would lower the rate of ASD.

Methods

The authors retrospectively identified patients who underwent 1 or 2 levels of lumbar fusion from November 2013 to April 2024 at a single academic institution. The primary outcome was reoperation for ASD. Secondary outcomes included complications, reoperations, and long-term patient-reported outcomes (EuroQol 5-Dimension (EQ-5D), Oswestry Disability Index (ODI)).

Results

A total of 419 patients met inclusion criteria, including ≥ 12 months of follow-up or earlier re-operation: 259 underwent open spinal fusion surgery and 160 underwent MIS lumbar fusion. The mean follow-up period was 34 ± 27 months in the open group and 32 ± 28 months in the MIS group. The overall rate of reoperation for ASD was significantly higher in the open group (19% vs. 9%, p=0.003). In a subset of 108 patients for whom preoperative and 2-year follow-up patient-reported outcomes (PROMs) were available (68 open, 40 MIS), MIS surgery had significantly improved outcomes at 2 years comparing EQ-5D (0.86 ± 0.2 vs. 0.75 ± 0.2, p = 0.01) and ODI (13 ± 10 vs. 25 ± 21, p = 0.002).

Conclusions

MIS lumbar fusion is associated with a significantly lower rate of reoperation for ASD, and among patients with available 2-year PROMs, improved EQ-5D and ODI, when compared with open surgery.

DOI

10.1016/j.wneu.2026.125329

PMID

42744231

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

Want more like this?

Browse more from the feed. A free account unlocks the full feed, saving and communities.

Back to the research feed

Create a free account · Sign in