Luca Ricciardi1, Carmelo Lucio Sturiale2, Resi Pucci3, Gabriele Reale3, Vito Stifano4, Alessandro Izzo5, Andrea Perna6, Luca Proietti6, Stefano Forcato7, Krissia M Rivera Perla8, Stefano El Boustany9, Alessandro Olivi4, Filippo Maria Polli2. 1. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA; Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: ricciardi.lu@gmail.com. 2. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 3. Dipartimento di Scienze Odontostomatologiche e Maxillo Facciali, "Sapienza" Università di Roma, Rome, Italy. 4. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Rome, Italy. 5. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA; Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Rome, Italy. 6. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Istituto di Ortopedia, Università Cattolica del Sacro Cuore, Rome, Italy. 7. Unità operativa di neurochirurgia, Pia Fondazione Panico, Ospedale di Tricase (LE), Italy. 8. Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. 9. Unità operative di Ortopedia, Università La Sapienza, ICOT, Latina, Italy.
Abstract
BACKGROUND: Despite recent treatment developments, back pain and related disabilities still represent a challenge for practitioners. Among the available surgical techniques, many different features and outcomes have been investigated; however, aesthetic result was missing among them. The present investigation was designed to prospectively compare patient-oriented aesthetic results after minimally invasive surgery (MIS) and standard open surgery (SOS) for the lumbar spine. METHODS: This was a prospective observational study with 1-year follow-up. Patients who underwent SOS were assigned to group 1 and MIS to group 2. Patient-oriented aesthetic result evaluation was collected using a dedicated visual aesthetic analogue scale. The Vancouver Scar Scale was used to exclude objective underlying influencing factors. The Oswestry Disability Index and a 10-point itemized visual analogue scale for back pain were administered to assess the clinical and functional status. Follow-up data were collected before discharge at 1, 6, and 12 months. Statistical analysis was conducted, and P < 0.05 was considered as significant. RESULTS: We enrolled 74 patients, 44 in group 1 and 30 in group 2. The 2 groups were homogeneous for demographic and clinical data. No clinical or functional differences were measured at the end of follow-up. Visual aesthetic analogue scale reported greater mean values in group 1 at every follow-up time. CONCLUSIONS: Patients seem to prefer the aesthetic result from a single midline incision after SOS compared with MIS. The use of specific techniques could be considered if there is scientific evidence reporting greater aesthetic outcome, having similar clinical and functional ones.
BACKGROUND: Despite recent treatment developments, back pain and related disabilities still represent a challenge for practitioners. Among the available surgical techniques, many different features and outcomes have been investigated; however, aesthetic result was missing among them. The present investigation was designed to prospectively compare patient-oriented aesthetic results after minimally invasive surgery (MIS) and standard open surgery (SOS) for the lumbar spine. METHODS: This was a prospective observational study with 1-year follow-up. Patients who underwent SOS were assigned to group 1 and MIS to group 2. Patient-oriented aesthetic result evaluation was collected using a dedicated visual aesthetic analogue scale. The Vancouver Scar Scale was used to exclude objective underlying influencing factors. The Oswestry Disability Index and a 10-point itemized visual analogue scale for back pain were administered to assess the clinical and functional status. Follow-up data were collected before discharge at 1, 6, and 12 months. Statistical analysis was conducted, and P < 0.05 was considered as significant. RESULTS: We enrolled 74 patients, 44 in group 1 and 30 in group 2. The 2 groups were homogeneous for demographic and clinical data. No clinical or functional differences were measured at the end of follow-up. Visual aesthetic analogue scale reported greater mean values in group 1 at every follow-up time. CONCLUSIONS:Patients seem to prefer the aesthetic result from a single midline incision after SOS compared with MIS. The use of specific techniques could be considered if there is scientific evidence reporting greater aesthetic outcome, having similar clinical and functional ones.
Authors: Marco Passiatore; Rocco De Vitis; Andrea Perna; Marco D'Orio; Vitale Cilli; Giuseppe Taccardo Journal: Eur J Orthop Surg Traumatol Date: 2020-05-13