Is Minimally Invasive Spinal Surgery Superior to Endoscopic Spine Surgery in Postoperative Radiologic Outcomes of Lumbar Spine Degenerative Disease? A Systematic Review

Kashyap Patel; Mandara Muralidhar Harikar; Tejas Venkataram; Vishal Chavda; Nicola Montemurro; Marjan Assefi; Namath Hussain; Vicky Yamamoto; Babak Kateb; Kai-Uwe Lewandrowski; Giuseppe E. Umana

doi:10.1055/a-2029-2694

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

J Neurol Surg A Cent Eur Neurosurg 2024; 85(02): 182-191
DOI: 10.1055/a-2029-2694

Review Article

Is Minimally Invasive Spinal Surgery Superior to Endoscopic Spine Surgery in Postoperative Radiologic Outcomes of Lumbar Spine Degenerative Disease? A Systematic Review

Kashyap Patel

¹Baroda Medical College, India, Vadodara, Gujarat, India

²Society for Brain Mapping & Therapeutics (SBMT), Los Angeles, California, United States

,

Mandara Muralidhar Harikar

³Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy

,

Tejas Venkataram

²Society for Brain Mapping & Therapeutics (SBMT), Los Angeles, California, United States

³Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy

,

Vishal Chavda

⁴Department of Pathology, Stanford School of Medicine, Stanford University Medical Center, San Francisco, California, United States

⁵Department of Medicine, Multispeciality, Trauma and ICCU Center, Sardar Hospital, Ahmedabad, Gujarat, India

,

Nicola Montemurro

⁶Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, Pisa, Italy

,

Marjan Assefi

⁷University of North Carolina at Greensboro, Greensboro, North Carolina, United States

,

Namath Hussain

⁸Department of Neurosurgery, Loma Linda University, Loma Linda, California, United States

,

Vicky Yamamoto

⁹University of Southern California Keck School of Medicine, The University of Southern California Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, California, United States

¹⁰University of Southern California-Norris Comprehensive Cancer Center, Los Angeles, California, United States

¹¹Brain Mapping Foundation (BMF), Los Angeles, California, United States

,

Babak Kateb

¹¹Brain Mapping Foundation (BMF), Los Angeles, California, United States

¹²Brain Technology and Innovation Park, Los Angeles, California, United States

,

Kai-Uwe Lewandrowski

¹³Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, Arizona, United States

,

Giuseppe E. Umana

³Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy

› Author Affiliations

Abstract

Background Minimally invasive spinal surgery (ESS) are both well-established surgical techniques for lumbar spinal stenosis; however, there is limited literature comparing the efficacy of the two techniques with respect to radiologic decompression data.

Methods In this review, PubMed, Google Scholar, and Scopus databases were systematically searched from inception until July 2022 for studies that reported the radiologic outcomes of endoscopic and minimally invasive approaches for decompressive spinal surgery, namely, the spinal canal area, neural foraminal area, and neural foraminal heights.

Results Of the 378 articles initially retrieved using MeSH and keyword search, 9 studies reporting preoperative and postoperative spinal areas and foraminal areas and heights were finally included in our review. Of the total 581 patients, 391 (67.30%) underwent MISS and 190 (32.70%) underwent ESS. The weighted mean difference between the spinal canal diameter in pre- and postoperative conditions was 56.64 ± 7.11 and 79.52 ± 21.31 mm² in the MISS and ESS groups, respectively. ESS was also associated with a higher mean difference in the foraminal area postoperatively (72 ± 1 vs. 35.81 ± 11.3 mm² in the MISS and ESS groups, respectively), but it was comparable to MISS in terms of the foraminal height (0.32 ± 0.037 vs. 0.29 ± 0.03 cm in the MISS and endoscopic groups, respectively).

Conclusions Compared with MISS, ESS was associated with improved radiologic parameters, including spinal canal area and neural foraminal area in the lumbar spinal segments. Both techniques led to the same endpoint of neural decompression when starting with a more severe compression. However, the present data do not allow the correlation of the radiographic results with the related clinical outcomes.

Keywords

minimally invasive spinal surgery - spinal endoscopy - degenerative spinal disease - lumbar spinal decompression

Full Text

References

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Supplementary Material

Supplementary Material