Category: Spine Pain | Author: Stefano Sinicropi
A new study that was presented at the AAOS 2020 Virtual Education Experience found that patients who undergo certain types of minimally invasive spinal procedures can quit opioids sooner than those that get the open operation, among other benefits.
For the study, researchers at the Hospital for Special Surgery in New York City examined the recovery journey of patients undergoing minimally invasive spinal decompression and minimally invasive spinal fusion to correct a single-level issue in their spine. Results were then compared to one another as well as to the same procedure using the open technique.
Researchers uncovered that it took 117 decompression patients a median of three days to discontinue opioid medications, while it took an average of seven days for 51 spinal fusion patients. They also noted that the average decompression patient was back driving within 14 days, whereas it took 18 days for the average fusion patient. The study didn’t specify exactly how long patients with open spinal fusion or open decompression procedures can expect to be on pain medications or until they can get back behind the wheel, but the lead researcher did call the difference “striking.”
“Our study is the first of its king 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 Sheeraz Qureshi, MD, lead researcher and spine surgeon at HHS. “All the patients in both groups were able to resume driving and return to work within three weeks of surgery. When you compared this time frame to that of standard open spinal fusion surgery, it’s really striking. Patients having a standard spinal fusion could take six months or longer for a full recovery.”
While Dr. Qureshi is championing his study as a first-of-its-kind, it’s not exactly a ground-breaking revelation. A minimally invasive operation, by nature of its name, is much less invasive on the patient than a traditional open procedure. Instead of a large opening that allows the surgeon to visualize the surgical site with their own eyes, a minimally invasive operation relies on smaller incisions and the use of microcameras to allow the surgeon to view the surgical location with the assistance of a relayed video feed. Because it’s so much less taxing on the patient, it would be shocking if patients didn’t stop an opioid regimen sooner or begin driving quicker after the operation compared to the open procedure. This study confirmed what common sense would have led us to believe.
However, the study does approach a more salient point when we consider the idea that if minimally invasive procedures produce better recovery outcomes, why isn’t that type of operation the standard for every patient? The answer to that question has multiple levels.
For starters, not every patient and condition is best treated with a minimally invasive approach. Some spinal tumors and conditions are best viewed and treated with the open technique, so it’s not a perfect solution. Also, the equipment needed is expensive, and not every medical facility will have access to these new technologies. If the doctor has more experience with the open technique because that’s what technology limitations have allowed for, a longer recovery with a higher chance of surgical success may be a better route to pursue. Finally, minimally invasive operations tend to be more complex and harder to perform for the surgeon compared to open techniques, so it’s not like it’s just a simple switch to a different operation. It takes precision and a unique set of skills to be able to perform a minimally invasive operation, even on the ideal patient.
Dr. Sinicropi is one of those surgeons who is not only comfortable performing minimally invasive operations, he’s performed thousands of successful surgeries to back up his abilities. He has the skill to allow his patients decide which surgical route is best for them. And if quitting opioids or getting back behind the wheel sooner are important to you, a minimally invasive operation might be right for you. For more information, reach out to Dr. Sinicropi’s office today.