Back Muscles Injury during Posterior Lumbar Spine Surgeries: Minimally Invasive versus Open Approaches—A Review of the Literature

Abstract

Background data: The use of less-invasive procedures during surgery for thoracolumbar and lumbar problems has grown in importance. Mini-open or minimally invasive procedures lessen intraoperative bleeding and postoperative back pain compared with open techniques. Uncertainty persists on whether minimally invasive surgeries cause less paraspinal muscle injury than open surgery. According to some reports, compared with open surgery, minimally invasive surgeries might result in less muscle atrophy and fat in fi ltration. Purpose: This study aimed to fi nd whether minimally invasive posterior lumbar spine surgery can lessen paraspinal muscle damage, restrict alterations in muscular structure and function, and improve functional outcomes. Study design: A literature review was performed. Patients and methods: A cross-referencing and extramanual search of the literature in PubMed and MEDLINE, the Cochrane Library databases, and Google Scholar search was conducted. Studies comparing traditional open surgery with minimally invasive or percutaneous procedures were included. In total, 40 studies comparing both techniques were found and analyzed. The muscle state assessment was extended up to 2 years in human studies. Results: A total of 11 studies were conducted on experimental animals, and the remaining studies were either case e control studies, case series, or comparative studies comparing the size of the multi fi dus muscle between patients with various lumbar spine disorders treated either conventionally or using minimally invasive techniques. Conclusion: Even though the degree of evidence is relatively weak, the present study revealed that the minimally invasive posterior spinal techniques have some advantages over the open techniques, such as less damage to the multi fi dus muscle, which is supported by the literature review. The association between changes in muscular structure and pain, strength, and quality of life needs to be better understood via research. These investigations ought to focus on the surgical approach (2022ESJ257).