{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T16:11:43Z","timestamp":1770912703019,"version":"3.50.1"},"reference-count":27,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T00:00:00Z","timestamp":1684800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: In clinical outcome studies, patient input into the factors that drive higher satisfaction with lumbar minimally invasive spinal surgery (MISS) is rare. The skin incision is often the only visible consequence of surgery that patients can assess. The authors were interested in patients\u2019 opinions about the type of lumbar paramedian minimally invasive spinal (MIS) skin incision employed during MISS and how novel skin incisions could impact patients\u2019 interpretation of the outcome. The authors wanted to compare traditional lumbar stab incisions to three novel lumbar paramedian (MIS) skin incisions to determine if further study is indicated. The primary objective was to examine patient satisfaction and perceptions regarding lumbar paramedian MIS skin incisions. Methods: We reviewed the literature and conducted a patient opinion survey. Responses were solicited from back pain patients from a single chiropractic office. Survey questions regarding novel skin incisions for minimally invasive spine surgery (NSIMISS) were conceptualized. The three novel skin incisions were designed using Langer\u2019s lines to reduce the total number of incisions; improve patient satisfaction; increase ease of surgical approach\/fixation; and reduce operative time\/radiation exposure. Results: One hundred and six participants were surveyed. When shown traditional lumbar paramedian MIS skin stab incisions, 76% of respondents indicated negative responses, n = 65. The majority of patients chose traditional stab incisions (n = 41) followed by novel larger intersecting incisions (n = 37). The least popular incisions were the novel horizontal (n = 20) and the novel mini oblique (n = 5) incisions. Female patients worried more than male patients about how their incision looked. However, there was no statistically significant difference (p value of 0.0418 via Mann\u2013Whitney U one-tailed test and p value of 0.0836 via Mann\u2013Whitney U two\u2013tailed test). Patients less than or equal to 50 years of age worried more than patients over 51 years of age, which was statistically significant (p value of 0.0104 via Mann\u2013Whitney U one-tailed test and p value of 0.0208 via Mann\u2013Whitney U two-tailed test). Conclusions: Patients do have opinions on the type of lumbar paramedian MIS skin incision used. It appears that younger patients and female patients worry most about how the incision on their back looks after surgery. A larger population of patients across many demographics is needed to validate these findings.<\/jats:p>","DOI":"10.3390\/jpm13060878","type":"journal-article","created":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T03:20:06Z","timestamp":1684812006000},"page":"878","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Patient Perceptions of Paramedian Minimally Invasive Spine Skin Incisions"],"prefix":"10.3390","volume":"13","author":[{"given":"Kimberly","family":"Quiring","sequence":"first","affiliation":[{"name":"3700 E. Williams Field Rd., Gilbert, AZ 85295, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgan P.","family":"Lorio","sequence":"additional","affiliation":[{"name":"Advanced Orthopedics, 499 E. Central Pkwy, Ste. 130, Altamonte Springs, FL 32701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge Felipe Ram\u00edrez","family":"Le\u00f3n","sequence":"additional","affiliation":[{"name":"Minimally Invasive Spine Center, Reina Sof\u00eda Clinic, Bogot\u00e1 104-76, Colombia"},{"name":"Department of Orthopaedics, Fundaci\u00f3n Universitaria Sanitas, Bogot\u00e1 104-76, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo S\u00e9rgio Teixeira","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Pain and Spine Minimally Invasive Surgery Service, Gaffre e Guinle University Hospital, Rio de Janeiro 20270-004, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossano Kepler Alvim","family":"Fiorelli","sequence":"additional","affiliation":[{"name":"Department of General and Specialized Surgery, Gaffr\u00e9e e Guinle University Hospital, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro 20270-004, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7842-2914","authenticated-orcid":false,"given":"Kai-Uwe","family":"Lewandrowski","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Fundaci\u00f3n Universitaria Sanitas, Bogot\u00e1 104-76, Colombia"},{"name":"Center for Advanced Spine Care of Southern Arizona, Tucson, AZ 85712, USA"},{"name":"Department of Orthopedics, Hospital Universit\u00e1rio Gaffre e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-004, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"753","DOI":"10.3171\/2021.10.SPINE211128","article-title":"Minimally invasive versus open lumbar spinal fusion: A matched study investigating patient-reported and surgical outcomes","volume":"36","author":"Mooney","year":"2021","journal-title":"J. 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