Comparative Analysis of Open vs Minimally Invasive Approaches in Lumbar Spine Surgery A Multi Center Study

Background: Lumbar spine disorders often require surgical intervention, with open lumbar surgery and minimally invasive spine surgery offering different risk-benefit profiles. Objective: This prospective study aims to compare intraoperative, postoperative, and recovery outcomes between open and minimally invasive approaches for lumbar spine surgery in a tertiary-level hospital in Bangladesh. Method: A prospective multi-center study was conducted from January 2020 to June 2024, involving 748 patients (OLS: 62%, MISS: 38%). Outcome measures included intraoperative blood loss, operative duration, hospital stay, complication rates, and patient-reported satisfaction scores. Result: Patients undergoing MISS had a 42% reduction in intraoperative blood loss compared to OLS (average 275 mL vs. 475 mL). The average hospital stay was 52% shorter for MISS patients (3.1 days) than for OLS patients (6.5 days). Complication rates for MISS were 7.3%, significantly lower than 14.9% for OLS, reflecting a 51% reduction. Specifically, infection rates were 2.8% for MISS versus 8.5% for OLS. Satisfaction rates were higher for MISS, with 92% of patients reporting positive outcomes, compared to 78% in the OLS group. However, operative times for MISS were 29% longer, averaging 110 minutes compared to 85 minutes for OLS. Conclusions: This prospective study indicates that MISS offers significant short-term benefits over OLS, including reduced blood loss, shorter hospital stays, and fewer complications, despite longer operative times. Further research is necessary to evaluate long-term outcomes.