Yuanqiao Kou1, Jianjun Chang2, Xiaoming Guan2, Chang Qiang2, Haoyu Feng3. 1. Shanxi Medical University, Taiyuan, Shanxi, China. 2. Department of Spinal Surgery, Affiliated Bethune Hospital of Shanxi Medical University, Taiyuan, Shanxi, China. 3. Department of Spinal Surgery, Affiliated Bethune Hospital of Shanxi Medical University, Taiyuan, Shanxi, China. Electronic address: fenghaoyuspine@126.com.
Abstract
OBJECTIVE: To compare the clinical efficacy and safety between the endoscopic lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases. METHODS: A exhaustive literature search was performed in the PubMed, Embase,Web of Science and Cochrane library databases. The studies published up to 1th of November 2020 that compared endoscopic lumbar interbody fusion（Endo-LIF） with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for treating lumbar degenerative diseases were retrieved. Data were extracted according to the predefined clinical outcome measures, the primary outcomes were preoperative and postoperative leg/back pain VAS and ODI score; the secondary outcomes were operation time and intraoperative blood loss; length of hospitalization; and the complications, reoperation, and fusion rate. Data analysis was conducted with Stata 15.0 software. RESULTS: A total of six studies involving 438 patients were included in the meta-analysis.The results of the merged analysis revealed similar complication rate, reoperation rate, and fusion rate , preoperative and postoperative leg/back pain VAS and ODI score (p＞0.05) for the two procedures. Nevertheless, with the exception of more operation time(p＜0.05), The Endo-LIF was associated with less intraoperative blood loss, shorter hospital stay(p＜0.05), and better long-term functional outcome when compared with the MIS-TLIF. CONCLUSION: Based on the evidence provided by our study, there is no significant difference in clinical efficacy and safety between the Endo-LIF and the MIS-TLIF in the treatment of lumbar degenerative diseases. Although the Endo-LIF requires a long operation time, it shows the advantages of less tissue trauma and rapid recovery after operation.
OBJECTIVE: To compare the clinical efficacy and safety between the endoscopic lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases. METHODS: A exhaustive literature search was performed in the PubMed, Embase,Web of Science and Cochrane library databases. The studies published up to 1th of November 2020 that compared endoscopic lumbar interbody fusion（Endo-LIF） with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for treating lumbar degenerative diseases were retrieved. Data were extracted according to the predefined clinical outcome measures, the primary outcomes were preoperative and postoperative leg/back pain VAS and ODI score; the secondary outcomes were operation time and intraoperative blood loss; length of hospitalization; and the complications, reoperation, and fusion rate. Data analysis was conducted with Stata 15.0 software. RESULTS: A total of six studies involving 438 patients were included in the meta-analysis.The results of the merged analysis revealed similar complication rate, reoperation rate, and fusion rate , preoperative and postoperative leg/back pain VAS and ODI score (p＞0.05) for the two procedures. Nevertheless, with the exception of more operation time(p＜0.05), The Endo-LIF was associated with less intraoperative blood loss, shorter hospital stay(p＜0.05), and better long-term functional outcome when compared with the MIS-TLIF. CONCLUSION: Based on the evidence provided by our study, there is no significant difference in clinical efficacy and safety between the Endo-LIF and the MIS-TLIF in the treatment of lumbar degenerative diseases. Although the Endo-LIF requires a long operation time, it shows the advantages of less tissue trauma and rapid recovery after operation.