Percutaneous endoscopic versus minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative diseases: a meta-analysis

Yi-Fan Song; Hui Wang; Jian-Wei Zhang; Yi-Ming Li; You-Di Xue; Yu-Fei Fu; Jie Li

doi:10.5114/wiitm.2022.118680

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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4/2022
vol. 17

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Neurosurgery

abstract:

Meta-analysis

Percutaneous endoscopic versus minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative diseases: a meta-analysis

Yi-Fan Song

¹

,

Hui Wang

²

,

Jian-Wei Zhang

²

,

Yi-Ming Li

²

,

You-Di Xue

²

,

Yu-Fei Fu

³

,

Jie Li

^{1, 2}

Graduate School, Bengbu Medical College, Bengbu, China
Department of Orthopaedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China
Department of Radiology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China

Videosurgery Miniinv 2022; 17 (4): 591–600

DOI: https://doi.org/10.5114/wiitm.2022.118680

Online publish date: 2022/08/10

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Introduction
Transforaminal lumbar interbody fusion (TLIF) is commonly used in patients with lumbar degenerative disease (LDD). The most commonly used techniques include minimally invasive TLIF (MIS-TLIF) and percutaneous endoscopic TLIF (PE-TLIF).

Aim
To compare the safety and clinical effectiveness of PE-TLIF and MIS-TLIF in treating LDD.

Material and methods
We screened for related articles in multiple scientific databases, namely, PubMed, Embase, Cochrane Library, Wanfang, VIP, and CINK, and analyzed the relative outcomes.

Results
Based on our inclusion criteria, we selected 8 studies for meta-analysis. There are a total of 229 patients who underwent PE-TLIF and 258 patients who underwent MIS-TLIF. MIS-TLIF and PE-TLIF have similar effectiveness in relieving leg pain and improving the Oswestry Disability Index. However, PE-TLIF is superior in relieving back pain. The pooled data of fusion rates, postoperative analgesic, and complication rates are comparable between the 2 groups. The pooled operation and intra-operative fluoroscopic time are both significantly higher in the PE-TLIF group than the MIS-TLIF group. The pooled intra-operative blood loss, incision length, duration from surgery to ambulation, and hospital stay are significantly lower in the PE-TLIF group than the MIS-TLIF group. Most of the endpoints reveal significant heterogeneity. The endpoints of operation time and intra-operative blood loss reveal significant publication bias.

Conclusions
Both PE-TLIF and MIS-TLIF are safe and effective interventions for patients with LDD. When compared, although MIS-TLIF results in reduced operative time, less intra-operative blood loss and enhanced post-operative recovery can be achieved by PE-TLIF.

keywords:

Percutaneous endoscopic versus minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative diseases: a meta-analysis

Yi-Fan Song 1 , Hui Wang 2 , Jian-Wei Zhang 2 , Yi-Ming Li 2 , You-Di Xue 2 , Yu-Fei Fu 3 , Jie Li 1, 2

transforaminal lumbar interbody fusion, lumbar degenerative disease, Oswestry Disability Index, meta- analysis

Yi-Fan Song

¹

,

Hui Wang

²

,

Jian-Wei Zhang

²

,

Yi-Ming Li

²

,

You-Di Xue

²

,

Yu-Fei Fu

³

,

Jie Li

^{1, 2}