Minimally Invasive Versus Traditional Open Transforaminal Lumbar Interbody Fusion for the Treatment of Single-Level Spondylolisthesis Grades 1 and 2: A Systematic Review and Meta-Analysis

Qin, Rongqing; Liu, Baoshan; Zhou, Pin; Yu, Yanbing; Hao, Jie; Yang, Kai Chiang; Xu, Tian; Zhang, Feng; Chen, Xiaoqing

doi:10.1016/j.wneu.2018.10.202

Cited by 43 publications

(49 citation statements)

References 35 publications

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“…But some scholars considered that MIS-TLIF was associated with a longer operation time 27 . A meta-analysis of Qin et al also proved that MIS-TLIF has a longer operation time 16 , and our research results are consistent with it. The dispute might be related to the learning curve of minimally invasive technology 28 .…”

Section: Discussionsupporting

confidence: 89%

“…In the last few decades, the advent of minimally invasive techniques in the spinal surgery led to the logical progression of TO-TLIF to MIS-TLIF 8 . The MIS-TLIF technique has been praised due to its advantages of smaller incision, less bleeding, and faster recovery compared with TO-TLIF 16 . However, there is still a lack of powerful evidence to prove which procedure has a better clinical efficacy in treating symptomatic low-grade DLS.…”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive versus traditional open transforaminal lumbar interbody fusion for the treatment of low-grade degenerative spondylolisthesis: a retrospective study

Qin

Liu

et al. 2020

Sci Rep

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This was a retrospective study. We aimed to compare the clinical efficacy and safety between minimally invasive and traditional open transforaminal lumbar interbody fusion in the treatment of low-grade lumbar degenerative spondylolisthesis (LDS). 81 patients with LDS grades 1 and 2 treated in our spinal department from January 2014 to July 2016 were retrospectively analyzed. The MIS-TLIF group included 23 males and 11 females, while the TO-TLIF group included 29 males and 18 females. Follow-up points were set at 7 days, 3 months, 6 months, 12 months postoperatively and the last follow-up. Various clinical and radiological indicators were used to evaluate and compare the efficacy and safety between the two procedures. 8 cases (3 in the MIS-TLIF group and 5 in the TO-TLIF group) were loss of follow-up after discharge. And the remaining 73 patients were followed up for at least 2 years. No statistically significant difference was observed in the terms of age, sex, BMI, slippage grade, and surgical segments. The MIS-TLIF group had a longer operation and fluoroscopy time compared with the TO-TLIF group. But the MIS-TLIF group was associated with less blood loss, ambulation time, hospital stay, and time of return to work. In each group, significant improvement were observed in BP-VAS, ODI and vertebral slip ratio at any time-point of follow-up when compared with the preoperative condition. When the time-point of follow-up was less than 1 year, the MIS-TLIF group had significant advantages in the BP-VAS and ODI compared with TO-TLIF group. But no significant difference was observed in the BP-VAS and ODI at either 12 month follow-up or the last follow-up. Besides, no statistical difference was detected in vertebral slip ratio at any time-point of follow-up between the two groups. Successful intervertebral bone fusion was found in all patients and no significant difference was found in the incidence of total complications. Thus, we considered that MIS-TLIF and TO-TLIF both achieve satisfactory clinical efficacy in the treatment of low-grade single-segment LDS. But MIS-TLIF appears to be a more efficacious and safe technique with reduced tissue damage, less blood loss and quicker recovery.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Minimally invasive versus traditional open transforaminal lumbar interbody fusion for the treatment of low-grade degenerative spondylolisthesis: a retrospective study

Qin

Liu

et al. 2020

Sci Rep

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“…This is the first network meta-analysis on comparative safety profile of PLIF, TLIF, and ALIF in patients with LDDD, yet our evidence is not the first synthesis in this field. Although some syntheses also investigated safety of LIF procedures before our study, 32 , 33 , 42 - 44 few of them focused on LDDD. 32 Pooling data from various populations usually leads to inappropriate estimate.…”

Section: Discussionmentioning

confidence: 99%

Safety of Lumbar Interbody Fusion Procedures for Degenerative Disc Disease: A Systematic Review With Network Meta-Analysis of Prospective Studies

Chi

Cheng

Kuo

et al. 2020

Global Spine Journal

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Study Design: A network meta-analysis. Objectives: Lumbar degenerative disc disease (LDDD) is an important issue in aging population, for which lumbar interbody fusion (LIF) is a feasible management in cases refractory to conservative therapy. There are various techniques available to perform LIF, including posterior (PLIF), transforaminal (TLIF), and anterior (ALIF) approaches. However, the comparative safety profile of these procedures remains controversial. Our study aimed to evaluate comparative adverse events of the LIF procedures in patients with LDDD. Methods: We searched 5 databases for relevant prospective cohort studies and randomized clinical trials. After quality assessments, we extracted neural, spinal, vascular, and wound events for conducting contrast-based network meta-analysis. Results were reported in risk ratio (RR), 95% confidence interval (CI), and surface under the cumulative ranking (SUCRA). Results: We identified 14 studies involving 921 participants with LDDD. Pooled result showed that open PLIF (OPLIF) leads to significantly higher overall adverse event rate than does open TLIF (OTLIF; RR = 3.43, 95% CI = 1.21-9.73). OTLIF confers the highest SUCRA in neural (78.7) and spinal (80.8) event rates. Minimally invasive TLIF has the highest SUCRA in vascular event (84.2), and minimally invasive PLIF has the highest SUCRA in wound event (88.1). No inconsistency or publication bias was detected in the results. Conclusions: Based on our results, perhaps OPLIF should be avoided in the management of LDDD due to the inferiority of overall complications. Specifically, TLIF seems to have the safest profile in terms of neural, spinal, and vascular events. Nevertheless, shared decision making is still mandatory when choosing the proper LIF procedure for patients with LDDD in clinical practice.

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“…Compared with TLIF, minimally invasive TLIF (MIS-TLIF) was demonstrated to have signi cant advantages, including a smaller incision, less severe paravertebral muscle dissection, less blood loss, less severe postoperative pain, and faster postoperative recovery 3,4 , and to yield comparable clinical results 5,6 . Nevertheless, due to the inadequate exposure of anatomical landmarks, traditional MIS-TLIF is often associated with insu cient decompression, the inaccurate placement of cages, and an increased risk of the malposition or perforation of pedicle screws 7 .…”

Section: Introductionmentioning

confidence: 99%

Which of MIS-TLIF and TLIF Can Leads to Better Pedicle Screws Placement Accuracy and Clinical Outcomes with Navigation Guidance?

Liu

Wu²,

Zuo

et al. 2021

Preprint

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Background Although previous studies have suggested that navigation can improve the accuracy of pedicle screw placement, there are still few studies comparing navigation-assisted transforaminal lumbar interbody fusion (TLIF) and navigation-assisted minimally-invasive TLIF (MIS-TLIF). The pedicle screw insertion entry point of navigation-assisted MIS-TLIF may be deflected from the planned entry point due to uneven bone-surface, which may result in misplacement. The purpose of this study was to explore the pedicle screws accuracy and clinical consequences of MIS-TLIF and TLIF both under O-arm navigation to determine which surgical method is better.MethodsA retrospective study of 54 patients who underwent single-segment navigation-assisted MIS-TLIF (NM-TLIF) or navigation-assisted TLIF (N-TLIF) was conducted. In addition to the patient's demographic characteristics, intraoperative indicators and complications, the ODI and VAS scores were recorded and analyzed preoperatively, at 1, 6, 12 months and at the final follow-up postoperatively. The clinical accuracy and absolute accuracy of pedicle screw placement was assessed by postoperative CT. Multifidus muscle injury were evaluated by T2-weighted MRI.ResultsCompared with N-TLIF, NM-TLIF was more advantageous in the incision length, intraoperative blood loss, drainage volume, time before ambulation, length of hospital stays, blood transfusion rate and analgesia rate (p<0.05). The ODI and VAS for low back pain scores were better than those of N-TLIF at 1 month and 6 months after surgery (p<0.05). There was no significant difference in the screw clinical qualitative accuracy (97.3% vs. 96.2%, p>0.05). The absolute quantitative accuracy results show that the axial translational error, sagittal translational error and sagittal angle error of NM-TLIF group are significantly greater than that in N-TLIF group (P<0.05). The mean T2-weighted signal intensity of multifidus muscle in the NM-TLIF group was significantly lower than that in the N-TLIF group (P<0.05)ConclusionsCompared with N-TLIF, NM-TLIF has more minimally invasive advantages, it does not yield a lower accuracy of screw placement and can achieve better symptom relief in the middle stage of postoperative recovery. However，more attention on real-time adjustment should be paid to pedicle insertion in NM-TLIF, rather than just following the entry point and trajectory of the intraoperative plan.

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Minimally Invasive Versus Traditional Open Transforaminal Lumbar Interbody Fusion for the Treatment of Single-Level Spondylolisthesis Grades 1 and 2: A Systematic Review and Meta-Analysis

Cited by 43 publications

References 35 publications

Minimally invasive versus traditional open transforaminal lumbar interbody fusion for the treatment of low-grade degenerative spondylolisthesis: a retrospective study

Minimally invasive versus traditional open transforaminal lumbar interbody fusion for the treatment of low-grade degenerative spondylolisthesis: a retrospective study

Safety of Lumbar Interbody Fusion Procedures for Degenerative Disc Disease: A Systematic Review With Network Meta-Analysis of Prospective Studies

Which of MIS-TLIF and TLIF Can Leads to Better Pedicle Screws Placement Accuracy and Clinical Outcomes with Navigation Guidance?

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