LAPAROSCOPIC FUSION OF THE LUMBAR SPINE IN A MULTICENTER SERIES OF THE FIRST 34 CONSECUTIVE PATIENTS

The purpose of this study was to describe the development of the lapar oscopic technique for anterior lumbar fusion and to evaluate the clini cal results of a first case series of patients. The in vivo porcine mo del was used first to develop the technique of transperitoneal laparos copic interbody fusion. Afterwards, operative time, blood loss, periop erative complications and length of stay were recorded for the first 3 4 patients who underwent laparoscopic fusion of L4-5 or L5-S1 at two m edical centers in 1994. Laparoscopic lumbar fusion was successful in 3 0 of 34 patients. Four patients early in the series successfully were converted to an open procedure because of poor visualization (two case s) or iliac venous injury (two cases). Transfusion was required in one patient; average blood loss was 128 ml. Operative time averaged 218 m in, hospitalization 3.67 days. Laparoscopic fusion is feasible and has minimal complications when a skilled laparoscopic surgeon is present for exposure. Minimal excisional trauma associated with this technique should result in decreased hospitalization and earlier recovery compa red with standard open techniques. Preliminary results indicate an ear lier discharge and return to work (3 weeks) than that expected for sta ndard open techniques.