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Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence

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Abstract

Purpose

This is a meta-analysis of randomized and non-randomized studies comparing the clinical and radiological efficacy of minimally invasive (MI) and conventional open transforaminal lumbar interbody fusion (open-TLIF) for degenerative lumbar diseases.

Methods

A literature search of the MEDLINE database identified 11 studies that met our inclusion criteria. A total of 785 patients were examined. Pooled estimates of clinical and radiological outcomes, and corresponding 95 % confidence intervals were calculated.

Results

The pooled data revealed that MI-TLIF was associated with less blood loss, shorter hospital stay, and a trend of better functional outcomes when compared with open-TLIF. However, MI-TLIF significantly increased the intraoperative X-ray exposure. Both techniques had similar operative time, complication rate, and re-operation rate.

Conclusions

Based on the available evidence, MI-TLIF for degenerative lumbar diseases might lead to better patient-based outcomes. MI-TLIF would be a promising procedure, but extra efforts are needed to reduce its intraoperative radiation exposure. More randomized controlled trials are needed to compare these two surgical options.

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References

  1. Karikari IO, Isaacs RE (2010) Minimally invasive transforaminal lumbar interbody fusion: a review of techniques and outcomes. Spine 35:S294–S301

    Article  PubMed  Google Scholar 

  2. Wu RH, Fraser JF, Hartl R (2010) Minimal access versus open transforaminal lumbar interbody fusion: meta-analysis of fusion rates. Spine 35:2273–2281

    Article  PubMed  Google Scholar 

  3. Tsahtsarlis A, Wood M (2012) Minimally invasive transforaminal lumber interbody fusion and degenerative lumbar spine disease. Eur Spine J. doi:10.1007/s00586-012-2376-y

    PubMed  Google Scholar 

  4. Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J (2011) Minimally invasive or open transforaminal lumbar interbody fusion as revision surgery for patients previously treated by open discectomy and decompression of the lumbar spine. Eur Spine J 20:623–628

    Article  PubMed  Google Scholar 

  5. Foley KT, Holly LT, Schwender JD (2003) Minimally invasive lumbar fusion. Spine 28:S26–S35

    PubMed  Google Scholar 

  6. Shunwu F, Xing Z, Fengdong Z, Xiangqian F (2010) Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases. Spine 35:1615–1620

    Article  PubMed  Google Scholar 

  7. Wang HL, Lu FZ, Jiang JY, Ma X, Xia XL, Wang LX (2011) Minimally invasive lumbar interbody fusion via MAST Quadrant retractor versus open surgery: a prospective randomized clinical trial. Chin Med J (Engl) 124:3868–3874

    Google Scholar 

  8. Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J (2010) Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Eur Spine J 19:1780–1784

    Article  PubMed  Google Scholar 

  9. Lee KH, Yue WM, Yeo W, Soeharno H, Tan SB (2012) Clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion. Eur Spine J. doi:10.1007/s00586-012-2281-4

    Google Scholar 

  10. Schizas C, Tzinieris N, Tsiridis E, Kosmopoulos V (2009) Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience. Int Orthop 33:1683–1688

    Article  PubMed  Google Scholar 

  11. Lau D, Lee JG, Han SJ, Lu DC, Chou D (2011) Complications and perioperative factors associated with learning the technique of minimally invasive transforaminal lumbar interbody fusion (TLIF). J Clin Neurosci 18:624–627

    Article  PubMed  Google Scholar 

  12. Scheufler KM, Dohmen H, Vougioukas VI (2007) Percutaneous transforaminal lumbar interbody fusion for the treatment of degenerative lumbar instability. Neurosurgery 60:203–213

    Article  PubMed  Google Scholar 

  13. Dhall SS, Wang MY, Mummaneni PV (2008) Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up. J Neurosurg Spine 9:560–565

    Article  PubMed  Google Scholar 

  14. Villavicencio AT, Burneikiene S, Roeca CM, Nelson EL, Mason A (2010) Minimally invasive versus open transforaminal lumbar interbody fusion. Surg Neurol Int 1:12

    Article  PubMed  Google Scholar 

  15. Adogwa O, Parker SL, Bydon A, Cheng J, McGirt MJ (2011) Comparative effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion: 2-year assessment of narcotic use, return to work, disability, and quality of life. J Spinal Disord Tech 24:479–484

    PubMed  Google Scholar 

  16. Villavicencio AT, Burneikiene S, Nelson EL, Bulsara KR, Favors M, Thramann J (2005) Safety of transforaminal lumbar interbody fusion and intervertebral recombinant human bone morphogenetic protein-2. J Neurosurg Spine 3:436–443

    Article  PubMed  Google Scholar 

  17. Peng CW, Yue WM, Poh SY, Yeo W, Tan SB (2009) Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine 34:1385–1389

    Article  PubMed  Google Scholar 

  18. Parker SL, Adogwa O, Bydon A, Cheng J, McGirt MJ (2011) Cost-effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis associated low-back and leg pain over two years. World Neurosurg. doi:10.1016/j.wneu.2011.09.013

    Google Scholar 

  19. Wang J, Zhou Y, Feng Zhang Z, Qing Li C, Jie Zheng W, Liu J (2012) Comparison of clinical outcome in overweight or obese patients after minimally invasive versus open transforaminal lumbar interbody fusion. J Spinal Disord Tech. doi:10.1097/BSD.0b013e31825d68ac

    Google Scholar 

  20. Chrastil J, Patel AA (2012) Complications associated with posterior and transforaminal lumbar interbody fusion. J Am Acad Orthop Surg 20:283–291

    Article  PubMed  Google Scholar 

  21. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 73:712–716

    Article  PubMed  Google Scholar 

  22. Detsky AS, Naylor CD, O’Rourke K, McGeer AJ, L’Abbe KA (1992) Incorporating variations in the quality of individual randomized trials into meta-analysis. J Clin Epidemiol 45:255–265

    Article  PubMed  CAS  Google Scholar 

  23. Kim CW, Lee YP, Taylor W, Oygar A, Kim WK (2008) Use of navigation-assisted fluoroscopy to decrease radiation exposure during minimally invasive spine surgery. Spine J 8:584–590

    Article  PubMed  Google Scholar 

  24. Tjardes T, Shafizadeh S, Rixen D, Paffrath T, Bouillon B, Steinhausen ES, Baethis H (2010) Image-guided spine surgery: state of the art and future directions. Eur Spine J 19:25–45

    Article  PubMed  Google Scholar 

  25. Lee JC, Jang HD, Shin BJ (2012) Learning curve and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion: our experience in 86 consecutive cases. Spine 37:1548–1557

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. From Zhejiang Spine Research Center, Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuanxi Road, Wenzhou, Zhejiang, 325000, China

    Nai-Feng Tian, Xiao-Lei Zhang, Hua-Zi Xu, Yong-Long Chi & Fang-Min Mao

  2. Department of Orthopaedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China

    Yao-Sen Wu

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  1. Nai-Feng Tian
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  2. Yao-Sen Wu
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  3. Xiao-Lei Zhang
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  4. Hua-Zi Xu
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Corresponding authors

Correspondence to Yong-Long Chi or Fang-Min Mao.

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Tian, NF., Wu, YS., Zhang, XL. et al. Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence. Eur Spine J 22, 1741–1749 (2013). https://doi.org/10.1007/s00586-013-2747-z

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  • DOI: https://doi.org/10.1007/s00586-013-2747-z

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