A comparison of perioperative charges and outcome between open and mini-open approaches for anterior lumbar discectomy and fusion

J Clin Neurosci. 2012 May;19(5):673-80. doi: 10.1016/j.jocn.2011.09.010. Epub 2012 Jan 10.


The objectives of this study were to examine charge data and long-term outcomes of two approaches for anterior lumbar interbody fusion: a mini-open lateral approach (extreme lateral interbody fusion, XLIF) and an open anterior approach (anterior lumbar interbody fusion, ALIF) through retrospective chart review. A total of 202 patients underwent surgery: 87 with ALIF (Open) and 115 with XLIF (Mini-open) procedures, all with transpedicular fixation. Complications occurred in 16.7% of Open, and 8.2% of Mini-open, procedures (p = 0.041). The mean charges ($US) for one-level Mini-open and Open procedures were $91,995 and $102,146, and for two-level procedures were $124,540 and $144,183, respectively. All differences were statistically significant (p < 0.05). This represents a 10% cost-savings, based on charges, for one-level and 13.6% for two-level Mini-open compared to Open procedures. Functional outcomes improved significantly at two years for both cohorts, although the difference between groups was not statistically significant. In conclusion, the Mini-open approach, compared to the Open, resulted in clinical as well as cost benefits with similar long-term outcomes.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Diskectomy / economics*
  • Diskectomy / mortality*
  • Female
  • Health Care Costs*
  • Humans
  • Intervertebral Disc / diagnostic imaging
  • Intervertebral Disc / pathology
  • Intervertebral Disc / surgery
  • Intervertebral Disc Displacement / diagnostic imaging
  • Intervertebral Disc Displacement / pathology
  • Intervertebral Disc Displacement / surgery*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / economics
  • Minimally Invasive Surgical Procedures / mortality
  • Radiography
  • Retrospective Studies
  • Spinal Fusion / economics*
  • Spinal Fusion / mortality*
  • Spondylosis / diagnostic imaging
  • Spondylosis / pathology
  • Spondylosis / surgery