Comparison of postoperative values for C-reactive protein in minimally invasive and open lumbar spinal fusion surgery

BACKGROUND: A major purported benefit of minimally-invasive spinal surgery (MIS) technique is less disruption of paraspinal soft tissues, but there is little quantifiable evidence of this in medical literature. Postoperative C-reactive protein (CRP) levels been shown to become more significantly elevated with larger surgical procedures, and this may allow for more measurable appreciation of any benefits of MIS verses open spinal surgery. METHODS: CRP values were measured prior to and at multiple time points following surgery in patients undergoing posterior spinal fusion using both open and minimally invasive techniques. RESULTS: Peak postoperative CRP was significantly lower in the 35 single-level minimally invasive procedures compared with the 11 single-level open procedures (13.5 vs. 21.3, P <0.01) and lower in the 12 two-level minimally invasive surgeries compared with 16 two-level open procedures (20.5 vs. 31.8, P <0.01). CONCLUSIONS: MIS lumbar fusion is associated with a lower peak in postoperative CRP compared with open surgery. This appears to support the notion that minimally invasive spine surgery technique leads to a measurable reduction in paraspinal soft tissue destruction mediated inflammation in the immediate postoperative period.