title: Is laparoscopic approach to lumbar spine fusion worthwhile?
abstract: BACKGROUND
  Laparoscopic lumbar spine fusion has been recently described. The aim of this study is to evaluate the safety and efficacy of this procedure for single- and multiple-level degenerative disc disease.
  
  
  METHODS
  Twenty-four consecutive laparoscopic interbody lumbar fusions were evaluated prospectively (18 single-level were compared with 6 multiple-level procedures). Results of the laparoscopic multiple-level procedures were further compared with 12 open multiple-level operations.
  
  
  RESULTS
  Twenty procedures were completed laparoscopically. The conversions were related to iliac vein lacerations (3 cases) and a mesenteric tear. Single-level cases had lower morbidity (22% versus 83%), shorter hospital stay (2 versus 10 days), and higher fusion rate (88% versus 50%) than multiple-level procedures. Overall results in the latter group were worse than in the matched open group.
  
  
  CONCLUSIONS
  Laparoscopic single-level fusion (L5-S1) is safe and carries the benefits of minimal access surgery. Morbidity after multiple level approach is high, and this procedure cannot be advocated at this time.
authors.affiliation: Department of Surgery, University of Southern California School of Medicine, Los Angeles, California 90033, USA.
authors.forename: N
authors.initials: N
authors.lastname: Katkhouda
authors.forename: G M
authors.initials: GM
authors.lastname: Campos
authors.forename: E
authors.initials: E
authors.lastname: Mavor
authors.forename: R J
authors.initials: RJ
authors.lastname: Mason
authors.forename: M
authors.initials: M
authors.lastname: Hume
authors.forename: A
authors.initials: A
authors.lastname: Ting
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D010535:Laparoscopy; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012447:Sacrum / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome