Minimally Invasive Versus Open Surgery for Degenerative Lumbar Spine Lesions: Review Article

Abstract

Degenerative lumbar spine disorders are commonly treated using decompression, posterior fusion, or interbody fusion procedures. Although conventional open surgery provides wide exposure of the operative field, it may cause extensive paraspinal muscle injury, greater blood loss, postoperative pain, prolonged hospitalization, and delayed recovery. Minimally invasive surgery was developed to reduce approach-related tissue damage while maintaining comparable neural decompression, stabilization, fusion, and clinical outcomes. Current evidence suggests that minimally invasive lumbar procedures may reduce intraoperative blood loss, hospital stay, and some perioperative complications compared with open surgery. However, reported differences in operative duration, quality-of-life improvement, and long-term functional outcomes remain inconsistent across techniques and pathological conditions. Minimally invasive procedures also have limitations, including expensive equipment, a steep learning curve, restricted visualization, and potential technical difficulties. Their cost-effectiveness may depend on whether reduced hospitalization, transfusion requirements, and recovery time compensate for higher procedural and equipment costs. This review compares minimally invasive and open surgical approaches for degenerative lumbar lesions, focusing on complications, hospital stay, operative time, blood loss, quality of life, and economic outcomes.