Real-world outcomes of minimally invasive posterior thoracic and lumbar spine fusion surgery versus open surgery in the Finnish Spine Registry.

BACKGROUND

A growing body of evidence is accumulating for the benefits of minimally invasive spine fusion. This study aimed to assess the differences in clinical outcomes, safety outcomes, medical resource use, and patient-related outcomes between Finnish patients undergoing posterior lumbar spinal fusion using an open approach (Open) or a minimally invasive approach with the VIPER PRIMETM System (MIS).

METHODS

This retrospective observational study utilized clinical data from the Finnish Spine (FinSpine) Registry, MyHealth service, and Social Insurance Institution of Finland (Kela) to evaluate spine fusion surgeries performed at Kuopio University Hospital (KUH) and Oulu University Hospital (OUH) in Finland. The primary outcome was total index length of stay (LOS) for MIS versus Open surgery. All other analyses were exploratory and included clinical, medical resource use, safety, and patient-reported outcomes. Propensity score matching was used to ensure balance across the Open and MIS groups, and a Poisson regression model was employed to adjust for residual imbalance.

RESULTS

A total of 522 patients were included in this study (139 MIS and 383 Open). There was no evidence to suggest a difference in LOS between the MIS and Open surgery groups after adjustment (P=0.20). No overall difference was found between hospitals either (P=0.75). Mean blood loss and skin-to-skin procedure time were lower in the MIS group. Mean Oswestry Disability Index (ODI), European Quality of Life Visual Analog Scale (EQ-VAS), European Quality of Life Visual Analog Scale (EQ-VAS), European Quality of Life Visual Analog Scale (EQ-VAS), and European Quality of Life Visual Analog Scale (EQ-VAS) were numerically lower and higher, respectively, than baseline at all evaluated timepoints up to 2 years. Sample sizes for the safety outcomes in this study were too low to draw any definitive conclusions.

CONCLUSIONS

In the present study, MIS techniques showed favorable clinical and healthcare resource use profiles, further supporting its use in spinal surgeries and potential value to patients and the healthcare system in Finland. Given that the rates of spinal fusion surgeries, particularly minimally invasive surgery, are expected to increase, understanding the impacts of these procedures on clinical, safety, and patient-related outcomes will be important to improve patient prognosis, and understanding the economic outcomes associated with these procedures will aid healthcare administrators and decision makers in assessing and planning for required resources.