Our Summary

This research paper is a review of studies comparing two types of surgery for a condition called multilevel lumbar spinal stenosis, which is a narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. The two surgeries compared are minimally invasive decompression (MID) and open laminectomy surgery (OLS).

The researchers looked at several different outcomes including how long patients stayed in the hospital, how long the operation took, how many complications there were, how much blood was lost during surgery, how many patients needed another operation, and how much lower back pain patients had a year after surgery.

After reviewing 3695 articles, they found 4 studies that included 618 patients. They found that there was no significant difference between the two types of surgery in most of the outcomes they looked at. However, they did find that patients who had the minimally invasive surgery lost less blood during the operation. This could mean that these patients were less likely to need a blood transfusion and had fewer complications related to blood loss.

However, the researchers also noted that the studies they looked at were quite different in their methods and techniques, which could have affected the results. Despite these differences, the study concludes that the minimally invasive surgery could have an advantage over the open surgery in terms of managing blood loss during the operation.

FAQs

  1. What is the difference between minimally invasive decompression (MID) and open laminectomy surgery (OLS) for multilevel lumbar spinal stenosis?
  2. What were the primary outcomes of studies comparing MID to OLS in patients with multilevel lumbar spinal stenosis?
  3. What advantages does MID have over OLS regarding intraoperative blood management?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal decompression is to consider minimally invasive decompression (MID) surgery as it may result in reduced intraoperative blood loss compared to open laminectomy surgery (OLS). This can decrease the need for transfusions and complications during the procedure. It is important to discuss with your doctor the best treatment option for your specific condition and to consider the potential benefits of a minimally invasive approach.

Suitable For

Patients with multilevel lumbar spinal stenosis are typically recommended spinal decompression, particularly those who are experiencing symptoms such as leg pain, numbness, weakness, and difficulty walking. Spinal decompression surgery may be considered for patients who have not found relief from conservative treatments such as physical therapy, medication, and injections. Additionally, patients with spinal stenosis causing compression of the spinal cord or nerves may benefit from spinal decompression to alleviate pressure and improve symptoms.

Timeline

  • Before spinal decompression:
  1. Patient experiences symptoms of lumbar spinal stenosis such as lower back pain, leg pain, numbness, and weakness.
  2. Patient undergoes diagnostic tests such as imaging scans (MRI, CT scan) to confirm the diagnosis.
  3. Patient may have tried conservative treatments such as physical therapy, medications, and injections with limited relief.
  • After spinal decompression:
  1. Patient undergoes minimally invasive decompression (MID) or open laminectomy surgery (OLS) for multilevel lumbar spinal stenosis.
  2. Length of hospital stay, operation time, complication rate, intraoperative blood loss, reoperation due to recurrence, and low back pain 1 year after surgery are monitored.
  3. Intraoperative blood loss is reduced in MID compared to OLS, leading to decreased need for transfusions and complications.
  4. Patient may experience improvement in symptoms and function post-surgery.

What to Ask Your Doctor

  1. What is the success rate of spinal decompression surgery for multilevel lumbar spinal stenosis?
  2. What are the potential risks and complications associated with minimally invasive decompression versus open laminectomy surgery?
  3. How long is the recovery period after spinal decompression surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. What factors will determine whether I am a suitable candidate for minimally invasive decompression surgery?
  6. How long do the effects of spinal decompression surgery typically last?
  7. Will I need any additional procedures or treatments in the future to maintain the results of the surgery?
  8. Are there any lifestyle changes or restrictions I should be aware of following spinal decompression surgery?
  9. What is the likelihood of needing a reoperation due to recurrence after spinal decompression surgery?
  10. How will my pain and mobility be affected after the surgery?

Reference

Authors: Sharma E, da Silva Lobo KE, Ayesha A, Łajczak P, Westphalen Pomianoski B, Silva YP, Morais David Silva YG. Journal: World Neurosurg. 2025 Jun;198:124031. doi: 10.1016/j.wneu.2025.124031. Epub 2025 May 6. PMID: 40339745