“…24 Five studies reported the VAS score of leg pain at the short-term follow-up, 17,18,21-23 and 6 studies reported at the long-term follow-up. 17-19,21-23 There were no significant differences in the VAS score of leg pain between the Endo-TLIF group and MIS-TLIF group either at the short-term (P = .81; SMD = .04 [95% CI = -.25−.33]) (Figure 3A) or long-term follow-up (P = .87; SMD = .03 [95% CI = -.32−.39]) (Figure 3B). Figure 3.Comparison of VAS score of leg pain at the short-term (A) and long-term follow-up (B) between the Endo-TLIF group and MIS-TLIF group.…”
Study design Systematic review and meta-analysis. Objective Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a classic surgical procedure for the treatment of lumbar degenerative diseases (LDD). With the development of endoscopic technology, endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) can also achieve adequate decompression and interbody fusion. However, whether Endo-TLIF is superior to MIS-TLIF has not been adequately studied. In this systematic review and meta-analysis, we aimed to evaluate the treatment difference between Endo-TLIF vs MIS-TLIF. Methods We conducted a systematic review and meta-analysis of the studies to compare the clinical outcomes and complications associated with Endo-TLIF vs. MIS-TLIF for the treatment of LDD. A literature search was conducted using the PubMed, Embase, Cochrane Library and Scopus databases for studies published up to April 1, 2022. Both retrospective and prospective studies that compared between Endo-TLIF and MIS-TLIF were included. Results A total of 8 studies involving 581 patients were finally included in this meta-analysis. Endo-TLIF significantly prolonged the operation time, but reduced the blood loss amount and length of hospital stay. Moreover, Endo-TLIF was superior to MIS-TLIF on relief of back pain and functional recovery in the early postoperative period. However, there were no significantly differences in long-term clinical outcomes, fusion rate and incidence of complications between Endo-TLIF and MIS-TLIF. Conclusions Endo-TLIF was similar to MIS-TLIF in the long-term clinical outcomes, fusion and complication rates. Endo-TLIF prolongs the operation time, but shortens the length of hospital stay, and has the advantages of less surgical trauma, less blood loss, faster recovery, and early postoperative back pain relief.
“…24 Five studies reported the VAS score of leg pain at the short-term follow-up, 17,18,21-23 and 6 studies reported at the long-term follow-up. 17-19,21-23 There were no significant differences in the VAS score of leg pain between the Endo-TLIF group and MIS-TLIF group either at the short-term (P = .81; SMD = .04 [95% CI = -.25−.33]) (Figure 3A) or long-term follow-up (P = .87; SMD = .03 [95% CI = -.32−.39]) (Figure 3B). Figure 3.Comparison of VAS score of leg pain at the short-term (A) and long-term follow-up (B) between the Endo-TLIF group and MIS-TLIF group.…”
Study design Systematic review and meta-analysis. Objective Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a classic surgical procedure for the treatment of lumbar degenerative diseases (LDD). With the development of endoscopic technology, endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) can also achieve adequate decompression and interbody fusion. However, whether Endo-TLIF is superior to MIS-TLIF has not been adequately studied. In this systematic review and meta-analysis, we aimed to evaluate the treatment difference between Endo-TLIF vs MIS-TLIF. Methods We conducted a systematic review and meta-analysis of the studies to compare the clinical outcomes and complications associated with Endo-TLIF vs. MIS-TLIF for the treatment of LDD. A literature search was conducted using the PubMed, Embase, Cochrane Library and Scopus databases for studies published up to April 1, 2022. Both retrospective and prospective studies that compared between Endo-TLIF and MIS-TLIF were included. Results A total of 8 studies involving 581 patients were finally included in this meta-analysis. Endo-TLIF significantly prolonged the operation time, but reduced the blood loss amount and length of hospital stay. Moreover, Endo-TLIF was superior to MIS-TLIF on relief of back pain and functional recovery in the early postoperative period. However, there were no significantly differences in long-term clinical outcomes, fusion rate and incidence of complications between Endo-TLIF and MIS-TLIF. Conclusions Endo-TLIF was similar to MIS-TLIF in the long-term clinical outcomes, fusion and complication rates. Endo-TLIF prolongs the operation time, but shortens the length of hospital stay, and has the advantages of less surgical trauma, less blood loss, faster recovery, and early postoperative back pain relief.
“…This avoids osteotomy and does not damage the posterior structures of the lumbar spine and paravertebral muscles, thereby reducing intraoperative blood loss. However, Lv et al [ 28 ] believe that MIS-TLIF still requires open incisions, including partial paravertebral muscle tissue separation, partial laminectomy, and facet joint resection, which inevitably damage the paravertebral muscles and pose a risk of spinal instability, resulting in increased intraoperative blood loss and a prolonged hospital stay [ 29 ]. Gao et al [ 13 ] conducted a case–control study and found that OLIF did not affect the function of the lumbar vertebral joints.…”
Section: Discussionmentioning
confidence: 99%
“…Contrastingly, MIS-TLIF requires the insertion of an intervertebral cage under endoscopic guidance, and the traditional cage is too bulky to pass through the working sleeve; therefore, a smaller cage must be used. This increases the risk of nonunion and cage subsidence, particularly in patients with severe osteoporosis [ 28 ]. This may explain why the fusion rate after MIS-TLIF was slightly lower than that after OLIF.…”
This meta-analysis compared the efficacy of oblique lumbar interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar degenerative diseases. A computer search for the published literature on OLIF and MIS-TLIF for the treatment of lumbar degenerative diseases in the PubMed, Web of Science, Embase, CINAHL, MEDLINE, Cochrane Library, and other databases was performed, from which 522 related articles were retrieved and 13 were finally included. Two reviewers independently extracted data from the included studies and analyzed them using RevMan 5.4. The quality of the studies was assessed using the Cochrane systematic analysis and the Newcastle–Ottawa scale. Meta-analysis showed that the blood loss [95% confidence intervals (CI) (− 121.01, − 54.56), $$P<0.001$$
P
<
0.001
], hospital stay [95% CI (− 1.98, − 0.85), $$P<0.001$$
P
<
0.001
], postoperative fusion rate [95%CI (1.04, 3.60), $$P=0.04$$
P
=
0.04
], postoperative disc height [95% CI (0.50, 3.63), $$P=0.01$$
P
=
0.01
], and postoperative foraminal height [95% CI (0.96, 4.13), $$P=0.002$$
P
=
0.002
] were all better in the OLIF group; however, the complication rates were significantly lower in the MIS-TLIF group [95% CI (1.01, 2.06), $$P=0.04$$
P
=
0.04
]. However, there were no significant differences between the two in terms of surgery time, patient satisfaction, or postoperative functional scores. The OLIF group had the advantages of lower blood loss, a shorter hospital stay, a higher postoperative fusion rate, and better recovery of the disc and foraminal heights, whereas MIS-TLIF had a relatively lower complication rate.
“…We observed good clinical outcomes in patients who underwent the POSDe technique of tubular surgery. There are various surgical procedures for lumbar degenerative spondylolisthesis, including endoscopic TLIF [ 20 , 21 , 22 ], lateral lumbar interbody fusion (LIF) by indirect decompression [ 13 , 23 , 24 , 25 , 26 , 27 ], as well as MIS-TLIF. Currently, there are a few reports comparing MIS-TLIF with LIF [ 28 , 29 , 30 , 31 , 32 ].…”
Although minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is the most common procedure in minimally invasive spine stabilization (MISt), details of the technique remain unclear. This technical report shows the mid-long-term clinical outcomes in patients who underwent posterior oblique square decompression (POSDe) with the three-step wanding technique of tubular MIS-TLIF for degenerative lumbar disease. Tubular MIS-TLIF (POSDe) was performed on 50 patients (males, 19; age, 69.2 ± 9.6 years), and traditional open surgery was performed (OS) on 27 (males, 4; age, 67.9 ± 6.6 years). We evaluated the clinical outcomes using the Visual Analog Scale for back pain, Japanese Orthopedic Association (JOA) scores, and JOA Back Pain Evaluation Questionnaire. We also assessed the fusion rate using the Bridwell grading system with computed tomography or plain radiography for at least 2 years postoperatively. Although there was no significant difference in the improvement rate of JOA scores between the two groups, the mean operation time and blood loss were significantly lower with MIS-TLIF than with OS. In the tubular MIS-TLIF group, there were no cases of deep wound infection; four cases had a pseudarthrosis, two had dural injury, and three had cage retropulsion. We revealed good clinical outcomes in patients who underwent POSDe.
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