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. 2024 Mar 1;49(5):356-363.
doi: 10.1097/BRS.0000000000004752. Epub 2023 Jun 20.

Single Long-Incision Minimally Invasive Surgery

Vishal Sarwahi  1 , Keshin Visahan  1 , Sayyida Hasan  1 , Aravind Patil  1 , Matan Grunfeld  2 , Aaron Atlas  1 , Jesse Galina  1 , Alexandre Ansorge  3 , Yungtai Lo  4 , Terry D Amaral  1 , Romain Dayer  3   5
Affiliations

Single Long-Incision Minimally Invasive Surgery

Vishal Sarwahi et al. Spine (Phila Pa 1976). .

Abstract

Study design: Retrospective cohort study.

Objective: The objective of this study is to determine differences in outcomes in patients with adolescent idiopathic scoliosis undergoing spinal deformity correction surgery using a posterior spinal fusion (PSF) approach versus single and triple-incision minimally invasive surgery (MIS).

Summary of background data: MIS increased in popularity as surgeons' focus moved towards soft tissue preservation, but it carries technical demands and increased surgical time compared with PSF.

Patients and methods: Surgeries performed from 2016 to 2020 were included. Cohorts were formed based on surgical approach: PSF versus single long-incision MIS (SLIM) versus traditional MIS [3-incision MIS (3MIS)]. There were a total of 7 subanalyses. Demographic, radiographic, and perioperative data were collected for the 3 groups. Kruskal-Wallis and χ 2 tests were used for continuous and categorical variables, respectively.

Results: Five hundred thirty-two patients met our inclusion criteria, 294 PSF, 179 3MIS, and 59 SLIM.Estimated blood loss (mL) ( P < 0.00001) and length of stay (LOS) ( P < 0.00001) was significantly higher in PSF than in SLIM and 3MIS. Surgical time was significantly higher in 3MIS than in PSF and SLIM ( P = 0.0012).Patients who underwent PSF had significantly lower postoperative T5 to T12 kyphosis ( P < 0.00001) and percentage kyphosis change ( P < 0.00001). Morphine equivalence was significantly higher in the PSF group during total hospital stay ( P = 0.0042).Patients who underwent SLIM and 3MIS were more likely to return to noncontact ( P = 0.0096) and contact sports ( P = 0.0095) within 6 months and reported lower pain scores ( P < 0.001) at 6 months postoperation.

Conclusion: SLIM has a similar operative time to PSF and is technically similar to PSF while maintaining the surgical and postoperative outcome advantages of 3MIS.

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Conflict of interest statement

The authors report no conflicts of interest.

References

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