3 years ago

Patient-oriented aesthetic outcome after lumbar spine surgery: a 1-year follow-up prospective observational study comparing minimally invasive and standard open procedures

Luca Ricciardi, Carmelo Lucio Sturiale, Resi Pucci, Gabriele Reale, Vito Stifano, Izzo Alessandro, Andrea Perna, Luca Proietti, Stefano Forcato, Krissia M. Rivera Perla, Stefano El Boustany, Alessandro Olivi, Filippo Maria Polli

Publication date: Available online 9 November 2018

Source: World Neurosurgery

Author(s): Luca Ricciardi, Carmelo Lucio Sturiale, Resi Pucci, Gabriele Reale, Vito Stifano, Izzo Alessandro, Andrea Perna, Luca Proietti, Stefano Forcato, Krissia M. Rivera Perla, Stefano El Boustany, Alessandro Olivi, Filippo Maria Polli

Abstract
Background

Despite recent treatment developments, back pain and related disabilities still represent a challenge for practitioners. Among the available surgical techniques, many different features and outcomes have been investigated; however, aesthetic result was missing among them. The present investigation was designed to prospectively compare patientoriented aesthetic result following minimally invasive surgery (MIS) and standard open surgery (SOS) for the lumbar spine.

Methods

This was a prospective observational study with 1-year follow-up. Patients who underwent SOS were assigned to group 1 and MIS to group 2. Patient-oriented aesthetic result evaluation was collected using a dedicated visual aesthetic analogue scale (VAAS). The Vancouver Scar Scale (VSS) was used to exclude objective underlying influencing factors.

The Oswestry disease index (ODI) and a ten-point-itemized visual analogue scale (VAS) for back pain were administered to assess the clinical and functional status. Follow-up data were collected before discharge at 1, 6, and 12 months. Statistical analysis was conducted and p-value <0.05 was considered as significant.

Results

We enrolled 74 patients, 44 in group 1 and 30 in group 2. The two groups were homogeneous for demographical and clinical data. No clinical or functional differences were measured at the end of follow-up. VAAS reported higher mean values in group 1 at every follow-up time.

Conclusions

Patients seem to prefer the aesthetic result from a single midline incision following SOS compared to MIS. The use of specific techniques could be considered if there is scientific evidence reporting higher aesthetic outcome, having similar clinical and functional ones.

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