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Meta-Analysis
. 2013 Aug;22(8):1741-9.
doi: 10.1007/s00586-013-2747-z. Epub 2013 Apr 10.

Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence

Nai-Feng Tian  1 , Yao-Sen Wu, Xiao-Lei Zhang, Hua-Zi Xu, Yong-Long Chi, Fang-Min Mao
Affiliations
Meta-Analysis

Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence

Nai-Feng Tian et al. Eur Spine J. 2013 Aug.

Abstract

Purpose: This is a meta-analysis of randomized and non-randomized studies comparing the clinical and radiological efficacy of minimally invasive (MI) and conventional open transforaminal lumbar interbody fusion (open-TLIF) for degenerative lumbar diseases.

Methods: A literature search of the MEDLINE database identified 11 studies that met our inclusion criteria. A total of 785 patients were examined. Pooled estimates of clinical and radiological outcomes, and corresponding 95% confidence intervals were calculated.

Results: The pooled data revealed that MI-TLIF was associated with less blood loss, shorter hospital stay, and a trend of better functional outcomes when compared with open-TLIF. However, MI-TLIF significantly increased the intraoperative X-ray exposure. Both techniques had similar operative time, complication rate, and re-operation rate.

Conclusions: Based on the available evidence, MI-TLIF for degenerative lumbar diseases might lead to better patient-based outcomes. MI-TLIF would be a promising procedure, but extra efforts are needed to reduce its intraoperative radiation exposure. More randomized controlled trials are needed to compare these two surgical options.

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Figures

Fig. 1
Fig. 1
Selection of relevant publications, reasons for exclusion
Fig. 2
Fig. 2
Forest plot illustrating operative time, X-ray exposure, blood loss, and hospital stay of meta-analysis comparing MI-TLIF with open-TLIF
Fig. 3
Fig. 3
Forest plot illustrating total complication rate and re-operation rate of meta-analysis comparing MI-TLIF with open-TLIF
Fig. 4
Fig. 4
Forest plot illustrating specified complication rate of meta-analysis comparing MI-TLIF with open-TLIF
Fig. 5
Fig. 5
Funnel plot of total complication rate
See this image and copyright information in PMC

Comment in

References

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