Minimally invasive surgery versus open surgery for intraspinal tumors: a meta-analysis based on 15 observational studies.

OBJECTIVES

This study compared the clinical outcomes of minimally invasive surgery (MIS) and open surgery (OS) for patients with intraspinal tumors.

METHODS

A systematic search of PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases was conducted to identify relevant studies. Continuous variables, including estimated blood loss, surgery duration, time to mobilization, length of hospitalization, visual analog scale (VAS) score, and incision length, were reported as mean differences (MD) with 95% confidence intervals (95% CIs). Dichotomous variables, such as gross total resection, blood transfusion, cerebrospinal fluid (CSF) leakage, and overall complications, were presented as risk ratios (RR) with 95% CIs. Meta-analyses were performed using RevMan 5.3.

RESULTS

Fifteen studies, comprising a total of 943 patients (488 in the MIS group and 455 in the OS group), met the inclusion criteria. The meta-analysis indicated that MIS significantly reduced estimated blood loss (MD = -76.73, 95% CI -102.56 to -50.91, P < 0.01), incision length (MD = -4.09, 95% CI -5.20 to -2.97, P < 0.01), VAS score (MD = -0.79, 95% CI -1.48 to -0.11, P = 0.02), time to mobilization (MD = -4.27, 95% CI -5.12 to -3.43, P < 0.01), length of hospitalization, (MD = -3.94, 95% CI -5.05 to -2.84, P < 0.01), and overall complications (RR = 0.40, 95% CI 0.25 to 0.64, P < 0.01) compared with OS. No significant differences were observed in surgery duration (MD = -28.67, 95% CI -58.58 to 1.23, P = 0.06), gross total resection (RR = 1.00, 95% CI 0.94 to 1.07, P = 0.92), blood transfusion (RR = 0.23, 95% CI 0.05 to 1.04, P = 0.06), or CSF leakage (RR = 0.50, 95% CI 0.24 to 1.04, P = 0.07).

CONCLUSION

Findings from this analysis suggest that MIS offers clinical advantages over OS in reducing blood loss, incision length, pain, time to mobilization, length of hospitalization, and overall complication rates.