Evaluation of invasiveness of full-endoscopic spine surgery based on blood data

• Published in: Journal of Spine Research Vol. 14; no. 8; pp. 1080 - 1085
• Main Authors: Kishima, Kazuya, Tachibana, Toshiya, Yoshie, Norichika, Maruo, Keishi, Kusukawa, Tomoyuki, Takagi, Kei, Arizumi, Fumihiro
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Spine Surgery and Related Research 20.08.2023; 一般社団法人 日本脊椎脊髄病学会
• Subjects: Blood data; full-endoscopic spine surgery; FESS; minimally invasive surgery; transforaminal approach; 低侵襲手術; 全内視鏡下脊椎手術; 経椎間孔アプローチ; 血液データ
• ISSN: 1884-7137; 2435-1563
• DOI: 10.34371/jspineres.2023-0802

Introduction: Full-endoscopic spine surgery (FESS) using transforaminal (TF) approach can be performed through an 8 mm skin incision under local anesthesia and is considered a minimally invasive spine surgery. The minimal invasiveness of FESS was evaluated using pre- and postoperative blood data.Material and Methods: The subjects of this study were 68 patients (39 males and 29 females) who underwent TF-FESS (FESS group), 24 patients (18 males and 6 females) who underwent laminectomy (L group), and 76 patients (38 males and 38 females) who underwent posterior interbody fusion (F group) for lumbar disc herniation and lumbar spinal canal stenosis between 1 vertebra from April 2021 to July 2022. The mean age of TF-FESS, laminectomy, and lumbar interbody fusion were 53.6, 73.2, and 71.0 years old. Preoperative and postoperative day 1 blood data were used.The items examined were creatinine kinase (CK), C-reactive protein (CRP), white blood cell count (WBC), and hemoglobin (Hb). The amount of change in each item in the FESS group was determined and compared with the L and F groups.Results: CK did not differ pre- and postoperatively in the FESS group (130 U/L vs 114 U/L, P=0.06), but was significantly increased postoperatively in the L group (158 U/L vs 269 U/L, P<0.05) and F groups (128 U/L vs 584 U/L, P<0.05). CRP did not differ pre- and postoperatively in the FESS group (0.44 mg/dL vs 0.51 mg/dL, P=0.35) and the L group (0.08 mg/dL vs 0.75 mg/dL, P=0.08), but was significantly increased postoperatively in the F group (0.34 mg/dL vs 1.24 mg/dL, P<0.05). WBC did not differ pre- and postoperatively in the FESS group (6,757/μL vs 6,982/μL, P=0.22), but was significantly increased postoperatively in the L (6,188/μL vs 9,263/μL, P<0.05) and F groups (6,137/μL vs 10,108/μL, P<0.05). Hb was significantly decreased postoperatively in the FESS group (13.9 g/dL vs 13.5 g/dL, P<0.05), L group (13.9 g/dL vs 12.3 g/dL, P<0.05) and F group (13.1 g/dL vs 11.2 g/dL, P<0.05). Comparison of pre- and postoperative changes showed significant differences among the three groups for all items.Conclusion: The results of this study show that TF-FESS is a minimally invasive spine surgery in terms of blood data.