Escaping Lumbar Fusion with a Small Outpatient Procedure (Long Term Follow-up)

13th Annual EANS Young Neurosurgeons’ Meeting. Hamburg, Germany on April 19-21, 2024

INTRODUCTION

The number of instrumented spinal operations in the U.S. has been steadily increasing to approximately 1.5 million per year presently. Many patients would prefer a smaller alternative.

Our study group consisted of patients that were offered lumbar fusion elsewhere and chose a small outpatient partial discectomy procedure instead. This was done with local anesthesia/IV sedation, with a small opening made in the skin to admit the specialized (nano) endoscope, no stitches needed. There was no cutting of muscle, bone, joint or ligament.

METHODS

70 patients were available for long term follow up. Of these, 45 were male and 25 female, ranging in age from early 20s to late 80s, with an average age of 45.6.

All patients had significant lumbar disc herniations before their procedures, with almost all having objective radiculopathy. The average follow up was 44.35 months.

RESULTS

89 % avoided fusion and 83 % avoided any further surgery during the follow up period.

No complications.

No new symptoms were caused.

SUMMARY / CONCLUSION
Spine fusions create permanent changes and sometimes lasting ill effects, therefore  small, effective alternative procedures, that are not traumatic and are very well tolerated, may be a consideration