Surprising Finding About MIS Versus Open Lumbar Discectomy
A study we'd have expected to find in favor of MIS did not
What’s the Claim?
A large, well-designed, and well-reported study from a good Canadian registry (the Canadian Spine Outcomes and Research Network, CSORN) found no important differences in leg pain, disability, or reoperation favoring minimally invasive (MIS) tubular lumbar discectomy over conventional open discectomy out to 12 months after surgery, and found that the MIS approach was associated with lower odds of achieving a clinically important reduction in back pain (odds ratio 0.66 [95% CI 0.44 to 0.99]) after accounting for relevant confounding variables. Surgical time was about 20 minutes shorter with the MIS approach, and the MIS approach was associated with a higher proportion of same-day discharges (73% versus 40%), but we caution readers that differences in patients and surgeons could easily account for those secondary findings.
