Minimally Invasive Versus Conventional Open Techniques in Spinal Tumor Surgery: A Systematic Outcome Comparison with Real-World Institutional Data

Abstract

Background: Spinal tumors are associated with significant morbidity, neurological compromise, and reduced quality of life. For decompression and stabilisation, conventional open spinal surgery has been the norm. However, minimally invasive spine surgery (MISS) has become a viable alternative with potential benefits such as less tissue damage, less blood loss, shorter hospital stays, and quicker recovery. While preserving comparable neurological and oncological efficacy, recent systematic studies have revealed that MISS improves perioperative outcomes. Aim: To compare perioperative, functional, and postoperative outcomes between minimally invasive and conventional open spinal tumor surgery techniques. Methods: Over the course of two years, this prospective observational study was carried out at Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute. Sixty individuals with either primary or metastatic spinal tumours were included in the study. Thirty patients who underwent minimally invasive procedures were compared to thirty patients who underwent traditional open surgery. Operative time, intraoperative blood loss, hospital stay, postoperative pain scores, neurological improvement, complications, and functional recovery were among the parameters assessed. The independent t-test and chi-square test were used for statistical analysis; p < 0.05 was deemed significant. Results: The MISS group demonstrated significantly lower intraoperative blood loss (312.4 ± 96.5 mL vs 648.7 ± 142.3 mL; p<0.001), shorter hospital stay (5.8 ± 1.6 days’ vs 9.7 ± 2.8 days; p<0.001), and lower postoperative pain scores (VAS 3.1 ± 1.2 vs 5.6 ± 1.5; p<0.001). Operative time was slightly longer in the MISS group but not statistically significant (p=0.08). Neurological recovery was comparable between groups, whereas functional recovery was significantly better in the MISS group. Postoperative complications were significantly lower in the MISS group (13.3% vs 33.3%; p=0.04). Conclusion: Minimally invasive spinal tumor surgery provides superior perioperative outcomes with reduced morbidity and shorter recovery compared with conventional open surgery, while maintaining comparable neurological outcomes. MISS may be considered a safe and effective alternative in appropriately selected spinal tumor patients. Keywords: Minimally invasive, spinal tumor surgery, conventional open surgery, neurological outcomes, spinal tumor patients