Symbol: Openversusminimally invasive transforaminal lumbar interbody fusion for single segment degenerative lumbar disease: A Meta-analysis

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Abstract

BACKGROUND:

Minimally invasive transforaminal lumbar interbody fusion can be performed through a tiny incision using a expandable channel. Compared with open transforaminal lumbar interbody fusion, minimally invasive transforaminal lumbar interbody fusion has smaller surgical field, more elaborate operation and less injury to the surrounding tissue which is conductive to accelerate overall recovery.

OBJECTIVE:

To evaluate the surgical outcome and clinical value between minimally invasive and open transforaminal lumbar interbody fusion in treatment of single segment degenerative lumbar disease.

METHODS:

The Cochrane library, PubMed database, Embase database, SCI database, CNKI database, Wanfang database and Chinese Biomedical database were searched for controlled trials, prospective cohort study and retrospective cohort study on the comparison between minimally invasive and open transforaminal lumbar interbody fusion in treatment of degenerative lumbar disease. Furthermore, we also manually searched the relevant references and four Chinese orthopedic journals. Methodology quality of the trials was critically assessed and the relative data were extracted. Cochrane Collaboration provided Revman 5.1 software was used for Meta-analysis.

RESULTS AND CONCLUSION:

Seven studies involving 856 cases were included. All the studies observed the surgical time, and the results of Meta-analysis showed that there was no statistically significant difference in the surgical time between minimally invasive and open transforaminal lumbar interbody fusion (P=0.11); six studies observed the intraoperative blood loss, and the results showed that the intraoperative blood loss of minimally invasive transforaminal lumbar interbody fusion was significantly less than that of the open transforaminal lumbar interbody fusion (P < 0.000 01); two studies observed the weight bearing time, and the results showed that the weight bearing time after minimally invasive transforaminal lumbar interbody fusion was shorter than that after open transforaminal lumbar interbody fusion (P < 0.000 01); six studies observed the intraoperative and postoperative complications, and the results showed that there were no significant differences between minimally invasive and open transforaminal lumbar interbody fusion (P=0.75); three studies observed the fusion rate, and the results showed there was no significant difference between minimally invasive and open transforaminal lumbar interbody fusion (P=1.00). The results showed that minimally invasive transforaminal lumbar interbody fusion was the ideal method for the treatment of single segment degenerative lumbar disease.

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