Is laparoscopic approach to lumbar spine fusion worthwhile?
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.
Katkhouda
N
N
Department of Surgery, University of Southern California School of Medicine, Los Angeles, California 90033, USA.
Campos
G M
GM
Mavor
E
E
Mason
R J
RJ
Hume
M
M
Ting
A
A
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