Long-term clinical outcome of minimally invasive versus open single-level transforaminal lumbar interbody fusion for degenerative lumbar diseases: a meta-analysis

被引:73
|
作者
Heemskerk, Johan L. [1 ,2 ]
Akinduro, Oluwaseun Oluwadara [1 ]
Clifton, William [1 ]
Quinones-Hinojosa, Alfredo [1 ]
Abode-Iyamah, Kingsley O. [1 ]
机构
[1] Mayo Clin Florida, Dept Neurol Surg, Jacksonville, FL 32224 USA
[2] OLVG, Dept Orthoped Surg, Amsterdam, Netherlands
来源
SPINE JOURNAL | 2021年 / 21卷 / 12期
基金
美国国家卫生研究院;
关键词
Degenerative spine disease; Degenerative lumbar disease; MIS-TLIF; Minimally invasive surgical transforaminal lumbar interbody fusion; OPEN-TLIF; Open transforaminal interbody fusion; long-term; Clinical outcome; PROM; Patient Reported Outcome Measures; Meta-analysis; Systematic review; OPEN SURGERY; SPONDYLOLISTHESIS; COMPLICATIONS; REGISTRY; BURDEN; TLIF;
D O I
10.1016/j.spinee.2021.07.006
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND CONTEXT: Minimally invasive surgical transforaminal lumbar interbody fusion (MIS-TLIF) was developed in addition to open-TLIF to minimize iatrogenic soft-tissue damage. A potential disadvantage of MIS-TLIF is inadequate visualization, which may lead to incomplete neural decompression and a less robust arthrodesis. This may cause long-term problems and result in decreased patient satisfaction. PURPOSE: To evaluate the long-term clinical outcome, measured by patient-reported outcomes (PROMs), of patients with degenerative lumbar diseases treated with single-level TLIF (open vs. minimally invasive) with a minimum follow-up of 2-years. STUDY DESIGN: Meta-analysis. METHODS: The systematic review was conducted according to the PRISMA guidelines. Relevant studies were identified from Pubmed, MEDLINE, EMBASE, Scopus, Web of Science, and CENTRAL from the date of inception to August 2019. The inclusion criteria were (1) longitudinal comparative studies of MIS-TLIF versus open-TLIF approach for degenerative spine disease (2) outcomes reported as PROMs, (3) minimum follow-up of 2-years. RESULTS: Sixteen studies were included in the analysis. In total, 1,321 patients were included (660 MIS-TLIF& 661 open-TLIF). The following PROMS were analyzed: EQ-5D, SF, ODI, and VAS. Both techniques resulted in significant improvement in PROM, which remained significant at 2-years follow-up. However, no significant differences were found in all PROMs at 2-years follow-up. Both treatments resulted in a high rate of spinal fusion (80.5% vs. 91.1%; p=.29) and low rate of reoperation (3.0% vs. 2.4%; p=.50) or adjacent segment disease (12.6% vs. 12.40%; p=.50). CONCLUSIONS: MIS-TLIF and open-TLIF have comparable long-term clinical outscomes. Both operations can significantly reduce pain and positively improve PROMs. No significant differences were found between both treatments in clinical outcomes at a follow-up of minimal 2-years. Therefore, MIS-TLIF seems to be an effective and safe alternative to traditional open-TLIF in the longterm. (C) 2021 Elsevier Inc. All rights reserved.
引用
收藏
页码:2049 / 2065
页数:17
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