Comparison of Perioperative and Postoperative Outcomes of Minimally Invasive and Open TLIF in Obese Patients: A Systematic Review and Meta‑Analysis

Abstract

Purpose Previous studies have demonstrated that minimally invasive (MI) transforaminal lumbar interbody fusion (TLIF) is comparable to the open approach in terms of efficacy and safety. However, few comparative studies of surgical procedures in patients with obesity show that they may react differently to open-TLIF (O-TLIF) and MI-LTIF approaches. Patients and Methods The main indicators were complications, visual analog scale (VAS) score, and Oswestry Disability Index (ODI) score, and secondary indicators were operative time, blood loss, and hospital stay. Results No significant differences in the VAS and ODI scores for back pain at the last follow-up and wound infection rates were observed between the two groups. Dural tear incidence and complication rate were significantly lower in the MI-TLIF group than that in the O-TLIF group (P = 0.002 and 0.001, respectively). No significant difference in operative time was found between the two groups. There was less blood loss and shorter hospital stay (P = 0.001 and 0.002, respectively) in the MI-TLIF group than that in the O-TLIF group. Conclusion Compared with O-TLIF, MI-TLIF is an effective and safe surgical option for patients with obesity, which resulted in similar improvements in pain and functional disability, as well as a lower complication rate.

Does the application of expandable cages in TLIF provide improved clinical and radiological results compared to static cages? A meta-analysis

“…The Newcastle–Ottawa Scale was used to assess the quality of the non-randomized trials ( 1 ). Each study was evaluated according to selection, comparability, and exposure/outcome.…”

“…There are several ways to surgically treat lumbar interbody fusion due to degenerative lumbar diseases; however, each has intrinsic benefits and drawbacks that must be addressed (1)(2)(3). The transforaminal lumbar interbody fusion (TLIF) technique improves surgical results while addressing the drawbacks of existing procedures, such as the risk of vascular damage in anterior lumbar interbody fusion and the amount of neural retraction necessary for posterior lumbar interbody fusion (4)(5)(6).…”

Comparative Effectiveness of Open Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion

“…All 20 included meta-analyses compared postoperative outcomes between O-TLIF and MI-TLIF in patients of any age with degenerative spine disease. [1][2][3][4][5][6]11,[18][19][20][21][22][23][24][25][26][27][28][29][30] Meta-analyses included 4-32 primary studies, were published between 2013 and 2022, and had total sample sizes of 394-2385. The characteristics of the 20 meta-analyses are described in Table 1.…”

“…For example, while Chen et al 5 report MI-TLIF as having a significantly lower visual analog scale-back pain (VAS-BP), Hammad et al 3 report no significant differences in VAS-BP amongst the interventions. Similarly, while Byvaltsev et al 2 report better Oswestry disability index (ODI) for MI-TLIF, Chen et al 6 report no significant difference in ODI between the interventions. Many such discrepancies exist between studies, and these differing conclusions amongst current literature bring about a need for an umbrella review.…”

Comparing Outcomes of Banana-Shaped and Straight Cages in Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Diseases: A Systematic Review and Meta-Analysis

“…These include conditions such as degenerative disc disease, spinal stenosis, and spondylolisthesis [ 1 - 3 ]. TLIF involves the placement of interbody cages within the intervertebral space, which facilitates fusion, restores vertebral height, and decompresses neural structures [ 4 , 5 ]. The choice of cage type, whether banana-shaped or straight bullet cages, has garnered considerable interest in recent years due to its potential impact on clinical and radiological outcomes [ 6 , 7 ].…”