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

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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Conflict of interest

The authors declare that they have no conflict of interest.

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

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Tian, N., Wu, Y., Zhang, X. 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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Keywords

  • Transforaminal lumbar interbody fusion
  • Minimally invasive
  • Outcome
  • Meta-analysis