Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Sep 20;13(1):241.
doi: 10.1186/s13018-018-0941-8.

Is minimally invasive superior than open transforaminal lumbar interbody fusion for single-level degenerative lumbar diseases: a meta-analysis

Aimin Li  1 , Xiang Li  2 , Yang Zhong  2
Affiliations
Review

Is minimally invasive superior than open transforaminal lumbar interbody fusion for single-level degenerative lumbar diseases: a meta-analysis

Aimin Li et al. J Orthop Surg Res. .

Abstract

Background: In recent years, the minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is increasingly used to manage the lumbar degenerative disease. However, whether MI-TLIF was superior than open transforaminal lumbar interbody fusion (O-TLIF) was controversial. The aim of this meta-analysis was to compare the clinical outcomes between the MI-TLIF and O-TLIF in single-level degenerative lumbar diseases.

Methods: Two reviewers independently searched EMBASE, PubMed, Web of Science, and Google database from inception to February 2018 for studies comparing the MI-TLIF and O-TLIF approach for single-level lumbar degenerative disease. The data were extracted and analyzed for primary outcomes such as total blood loss, visual analog score (VAS), and other secondary outcomes (length of hospital stay, operation time, fluroscopic time, and Oswestry Disability Index (ODI)). Meta-analysis was performed by Stata 12.0.

Results: Seven RCTs were finally included in this meta-analysis. Compared with O-TLIF, MI-TLIF was associated with significantly less blood loss (weighted mean difference (WMD) = - 291.46; 95% confidence interval (CI) - 366.66 to - 216.47; P = 0.000,). There was no significant difference between the length of hospital stay, postoperative VAS, and ODI. Compared with O-TLIF, MI-TLIF was associated with an increase of the fluroscopic time (P < 0.05).

Conclusion: The MI-TLIF showed significantly less blood loss compared with O-TLIF and more fluroscopic time. There was no significant difference between the length of hospital stay, postoperative VAS, and ODI. More high-quality studies and subsequent meta-analyses are needed in the future.

Keywords: Degenerative lumbar disease; Minimally invasive; Single-level; Transforaminal lumbar interbody fusion.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

None.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow of trials through the meta-analysis
Fig. 2
Fig. 2
The risk of bias summary, +, no bias; −, bias; ?, bias unknown
Fig. 3
Fig. 3
Risk of bias of summary of the included randomized controlled trials
Fig. 4
Fig. 4
Forest plots of the included studies comparing the total blood loss
Fig. 5
Fig. 5
Forest plots of the included studies comparing the length of hospital stay
Fig. 6
Fig. 6
Forest plots of the included studies comparing the operating time
Fig. 7
Fig. 7
Forest plots of the included studies comparing the postoperative VAS score
Fig. 8
Fig. 8
Forest plots of the included studies comparing the postoperative ODI
Fig. 9
Fig. 9
Forest plots of the included studies comparing the fluroscopic time
Fig. 10
Fig. 10
Sensitivity analysis of the total blood loss
Fig. 11
Fig. 11
Funnel plot of the total blood loss
Fig. 12
Fig. 12
Begg’s test for total blood loss
See this image and copyright information in PMC

Comment in

References

    1. Harms J, Rolinger H. A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author’s transl) Z Orthop Ihre Grenzgeb. 1982;120(3):343–347. doi: 10.1055/s-2008-1051624. - DOI - PubMed
    1. Hackenberg L, et al. Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results. Eur Spine J. 2005;14(6):551–558. doi: 10.1007/s00586-004-0830-1. - DOI - PMC - PubMed
    1. Houten JK, et al. Clinical and radiographically/neuroimaging documented outcome in transforaminal lumbar interbody fusion. Neurosurg Focus. 2006;20(3):E8. doi: 10.3171/foc.2006.20.3.9. - DOI - PubMed
    1. Kobayashi K, et al. Eur Spine J. 2018. Reoperation within 2 years after lumbar interbody fusion: a multicenter study. - PubMed
    1. Lee MJ, Mok J, Patel P. Transforaminal lumbar interbody fusion: traditional open versus minimally invasive techniques. J Am Acad Orthop Surg. 2018;26(4):124–131. doi: 10.5435/JAAOS-D-15-00756. - DOI - PubMed

MeSH terms

LinkOut - more resources