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Patients who undergo either minimally invasive lumbar decompression surgery or minimally invasive lumbar spine fusion surgery can expect to return to work and to resume driving within weeks of the procedure, not the months required to recover from open spinal surgery. And, they’ll be able to discontinue narcotics for pain fairly soon after surgery.

Those are the conclusions of a study from Hospital for Special Surgery (HSS) that compared short-term outcomes of the 2 minimally invasive procedures. The researchers found no statistically significant difference in the amount of time patients needed to return to work, while patients in the minimally invasive lumbar decompression group resumed driving 4 days sooner than those in the minimally invasive spine fusion group. Patients in both groups were able to discontinue narcotic pain medication within 1 week after surgery.

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The study was scheduled for presentation at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS), canceled due to the COVID-19 pandemic. The abstract has been published online as part of the AAOS Virtual Education Experience.

The findings are especially noteworthy, according to Sheeraz Qureshi, MD, MBA, HSS spine surgeon and the study’s senior investigator, because a standard open spinal fusion generally entails a much longer recovery and slower return to activities than a standard lumbar decompression.

“Our study is the first of its kind to look at return to activities and discontinuation of narcotic pain medication after single-level lumbar decompression or single-level lumbar spine fusion performed with a minimally invasive technique,” said Dr. Qureshi, who is also the Patty and Jay Baker Endowed Chair in Minimally Invasive Spine Surgery at HSS.

“In our study, all the patients in both groups were able to resume driving and return to work within 3 weeks of surgery. When you compare this time frame to that of standard open spinal fusion surgery, it’s really striking. Patients having a standard spinal fusion could take 6 months or longer for a full recovery.”

The study included patients who had elective single-level minimally invasive lumbar decompression or single-level minimally invasive lumbar spine fusion between April 2017 and July 2019 by a single orthopedic surgeon at HSS. Patients included in the analysis were driving or working before surgery. The researchers found the following:

• The 117 decompression patients took a median of 3 days to discontinue narcotic pain medication, while it took a median of 7 days for the 51 spinal fusion patients.
• The 88 decompression patients who were driving before surgery took a median of 14 days to resume driving; the 45 fusion patients who were driving preoperatively needed 18 days.
• No statistically significant difference was observed in the time patients in each group needed to return to work.

Source

Mok JK, Avani Vaishnav A, Gang CH, McAnany S, Iyer S, Albert TJ, Qureshi S. Return to Activities and Discontinuation of Narcotics after Minimally Invasive Lumbar Spine Surgery. Paper 316. AAOS Virtual Education Experience.