Why Is Open Back Surgery Outdated Comparing to Minimally Invasive Surgery

September 27, 2016

Back problems can occur due to a broad range of reasons. For example, some people experience spine problems due to age-related degeneration; others develop certain issues due to wear and tear, injuries, or accidents. Consulting your doctor regarding pain in the back is crucial because receiving treatment promptly allows you to recover fast. However, sometimes the injury to the spine is too severe and doesn’t tolerate traditional therapies. In these cases, your doctor recommends surgery. There are two types of surgery: open and minimally invasive. Although open surgery was widely performed, minimally invasive procedures took that throne. Throughout this article, you’re going to find out what makes open back surgeries outdated.

What is open back surgery?

Typically, if a traditional treatments prove ineffective in six to twelve months, your doctor may recommend surgery in case your back problem is severely affecting the quality of life. Traditionally, every spine-related surgery was performed as the open back procedure. The operation required opening the operative site with a large incision so the surgeon can view and access the affected area. In most cases, the surgeon would cut the surrounding tissue to reach the affected part of the spine. That’s why open back surgery is an invasive procedure.

Duration of open back surgery varied, but they usually last for up to a few hours and are associated with more anesthesia than other procedures, and greater blood loss. After the operation is complete, the patient spends at least two days in the hospital before being discharged home. The recovery time is long and requires strict adherence to the physical therapy recommended by the healthcare provider.

What is minimally invasive back surgery?

As the name suggests, minimally invasive back surgery is less stressful for the patient’s back than the open procedure. This type of operation doesn’t require a large incision and the surgeon doesn’t cut out surrounding tissues to reach the affected area. Instead, he/she just inserts required instruments through small incisions.

Minimally invasive back surgeries are performed in an outpatient setting, meaning the patient is discharged and allowed to go home the next day. Although this procedure also requires strict adherence to the physical therapy, the overall recovery time is significantly shorter than in open surgery. It’s needless to mention that non-invasive spine surgery is noticeably shorter than its counterpart.

Disadvantages of open back surgery

The best way to understand why open back surgery is becoming outdated is to take a look at the list of its drawbacks. They are:

  • High risk of infections
  • Pain
  • More anesthesia necessary due to longer duration of the procedure
  • Greater blood loss
  • Expensive
  • Long recovery
  • Large scar


We’re living in the era of constant progress in fields of technology, medicine, and science. The incredible progress enabled scientists to create a way of tackling common spine problems in a non-invasive manner that allows patients to recover faster, avoid small scars and excruciating pain associated with postoperative pain after open back surgery where a surgeon cuts tissues and muscles.

With constant progress of technology, scientists create new ways to do certain procedures, thus accelerating the duration of process and decreasing costs. Unfortunately, open back surgery doesn’t keep up with this tempo; it puts a patient into painful and long recovery that he/she can’t afford.

Isn’t open surgery more efficient?

The underlying idea behind minimally invasive procedures was to come up with the manner of operating spine-related issues in a non-invasive way but to accomplish same results as open surgeries do. Even though traditional, invasive, procedures are considered more useful, that’s not entirely correct.

For example, researchers from Norway investigated the efficacy of both invasive and non-invasive procedures in the lumbar spine. Their results, published in the BMJ, showed that the effectiveness of microdecompression is equivalent to laminectomy in the surgical treatment of central stenosis of the lumbar spine. Both treatment groups showcased favorable outcomes.

In fact, there’s a growing body of evidence confirming that minimally invasive procedures can accomplish same effects as their counterparts (just without the large scar and other consequences). For example, the Evidence-Based Spine-Care Journal published results of the review of studies which showed that minimally invasive spine surgery techniques are strongly associated with less postoperative pain, less blood loss, a shorter hospital stay, and a better functional outcome.

As you can see, the latter example showed that non-invasive approach could be even better than an open procedure, but it’s not the only research which confirmed its greater efficacy. A study published in The Spine Journal, showed that minimally invasive spinal fusion is a safe and efficient approach to treating grade I and II spondylolisthesis. The procedure is also associated with better functional outcomes.


The goal of minimally invasive surgery is to provide same benefits of the open procedure but without significant blood loss, pain, prolonged recovery or hospital stay, and without a large incision. The non-invasive method is also linked to low risk of infections comparing to its counterpart. Now that a growing number of studies are confirming that minimally invasive approach could be functionally better; in the near future we can expect even more non-invasive techniques that will allow surgeons to perform even the most demanding procedures this way.

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