Minimally Invasive Surgery vs. Open Surgery for Infectious Spondylodiscitis: A Systematic Review and Meta-Analysis

Abstract

Objective Minimally Invasive Spinal (MIS) Procedure has long been used for treating degenerative spinal disorders, however its usage for infectious diseases of the spine has not been described a lot in literatures. Through this meta-analysis, we aim to objectively describe the efficacy of MIS as compared to traditional open surgery (OS) in treating infectious spondylodiscitis. Methods A systematic search was conducted based on PRISMA guideline to identify relevant studies through PubMed, Google Scholar, and Cochrane database. A total of 4 studies (301 patients) were included, divided into 8 meta-analysis, processed using Review Manager 5.3. Results OS requires significantly longer hospital length of stay (p=0.0009, I2=0%, MD=–6.64) and higher blood loss (p<0.00001, I2=40%, MD=–264.31) as well as more postoperative blood transfusion (p<0.00001, I2=0%, MD=–1.58). Moreover, MIS has benefit in significantly shorter operation time (p<0.00001, I2=46%, MD=–30.07) and less complication rate (p=0.0002, I2=38%, MD=0.32). However, the two procedures do not differ significantly in terms of neurological improvement, recurrence rate, and mortality rate. Conclusion Current systematic review and meta-analysis suggest that MIS offers comparable efficacy as well as less hospital length of stay, blood loss, operation time, and complication rate compared to OS.

Keywords

• meta-analysis
• minimally invasive surgery
• open surgery
• spondylodiscitis