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| SUN Hao,LI Chen,NIE Guanglong.Meta-analysis of the clinical efficacies of unilateral biportal endoscopic lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases[J].Chinese Journal of Spine and Spinal Cord,2024,(4):389-401. |
| Meta-analysis of the clinical efficacies of unilateral biportal endoscopic lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases |
| Received:October 17, 2023 Revised:January 20, 2024 |
| English Keywords:Degenerative diseases of the lumbar spine Unilateral biportal endoscopic lumbar interbody fusio Minimally invasive transforaminal lumbar interbody fusion Meta-analysis |
| Fund:南京市中医药科技专项项目（ZYYB202224） |
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| English Abstract: |
| 【Abstract】 Objectives: To systematically evaluate the clinical efficacies of unilateral biportal endoscopic lumbar interbody fusion(ULIF) and minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) in the treatment of lumbar degenerative diseases(LDD). Methods: Clinical controlled studies on ULIF and MIS-TLIF in the treatment of LDD were systematically retrieved from Chinese and English databases, including CNKI, VIP, WanFang, SinoMed, PubMed, Cochrane Library, Embase, and Web of Science. The retrieval time limit was from the establishment of the database to September 2023. The quality of the included studies was evaluated by the Newcastle-Ottawa scale(NOS). The indexes of operation time, surgical bleeding, hospitalization time, visual analog scale(VAS), Oswestry disability index(ODI), incidence of complications, disc height, and fusion rate were extracted, and Meta-analysis was performed by RevMan 5.4.1 software. Results: A total of 11 studies were included, all of which were cohort studies, and all of which were evaluated as medium-high quality by NOS. There were 800 patients, including 380 in the ULIF group and 420 in the MIS-TLIF group. The results of Meta analysis showed that the hospitalization time[WMD=-0.75, 95%CI(-1.33, -0.17)], low back pain VAS(1-3 months after operation)[MD=-0.43, 95%CI(-0.70, -0.15)], low back pain VAS(final follow-up>1 year)[MD=-0.09, 95%CI(-0.18, -0.00)], ODI(1-3 months after operation)[MD=-1.37, 95%CI(-2.46, -0.28)], and intraoperative bleeding[MD=-78.72, 95%CI(-113.20, -44.23)] in the ULIF group were better than those in the MIS-TLIF group. The operation time[MD=30.28, 95%CI(13.86, 46.71)] in the MIS-TLIF group was better than that in the ULIF group. There were no significant differences in leg pain VAS(1-3 months after operation)[MD=-0.12, 95%CI(-0.30, 0.06)], leg pain VAS(final follow-up>1 year)[MD=-0.04, 95%CI(-0.15, 0.07)], ODI (final follow-up>1 year)[MD=-0.46, 95%CI(-1.02, 0.11)], lumbar lordosis angle[MD=0.39, 95%CI(-1.12, 1.90)], disc height[MD=0.03, 95%CI(-0.24, 0.30)], fusion rate[MD=0.97, 95%CI(0.92, 1.03)] and complication rate[MD=0.82, 95%CI(0.45, 1.48)]. Conclusions: Compared with MIS-TLIF, ULIF has advantages in improving low back pain symptoms and early recovery of function, reducing intraoperative blood loss, shortening hospital stay, which is less in surgical trauma and faster in recovery. There is no significant difference in long-term efficacy, complications, and fusion rate between the two methods. |
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