Phan Kevin, Thayaparan Ganesha K, Mobbs Ralph J
a Department of Neurosurgery , Neuro Spine Clinic, Prince of Wales Private Hospital, New South Wales, Australia and NeuroSpine Surgery Research Group (NSURG) , Sydney , Australia.
Br J Neurosurg. 2015;29(5):705-11. doi: 10.3109/02688697.2015.1036838. Epub 2015 May 12.
To assess the clinical and radiographic outcomes and complications of anterior lumbar interbody fusion (ALIF) versus transforaminal lumbar interbody fusion (TLIF).
A systematic literature search was conducted from six electronic databases. The relative risk and weighted mean difference (WMD) were used as statistical summary effect sizes.
Fusion rates (88.6% vs. 91.9%, P = 0.23) and clinical outcomes were comparable between ALIF and TLIF. ALIF was associated with restoration of disk height (WMD, 2.71 mm, P = 0.01), segmental lordosis (WMD, 2.35, P = 0.03), and whole lumbar lordosis (WMD, 6.33, P = 0.03). ALIF was also associated with longer hospitalization (WMD, 1.8 days, P = 0.01), lower dural injury (0.4% vs. 3.8%, P = 0.05) but higher blood vessel injury (2.6% vs. 0%, P = 0.04).
ALIF and TLIF appear to have similar success and clinical outcomes, with different complication profiles. ALIF may be associated with superior restoration of disk height and lordosis, but requires further validation in future studies.
评估前路腰椎椎间融合术（ALIF）与经椎间孔腰椎椎间融合术（TLIF）的临床、影像学结果及并发症。
从六个电子数据库进行系统的文献检索。相对风险和加权平均差（WMD）用作统计汇总效应量。
ALIF和TLIF的融合率（88.6%对91.9%，P = 0.23）及临床结果具有可比性。ALIF与椎间盘高度恢复（WMD，2.71mm，P = 0.01）、节段性前凸（WMD，2.35，P = 0.03）和整个腰椎前凸（WMD，6.33，P = 0.03）相关。ALIF还与更长的住院时间（WMD，1.8天，P = 0.01）、更低的硬脊膜损伤发生率（0.4%对3.8%，P = 0.05）相关，但血管损伤发生率更高（2.6%对0%，P = 0.04）。
ALIF和TLIF似乎具有相似的成功率和临床结果，但并发症情况不同。ALIF可能与更好地恢复椎间盘高度和前凸相关，但需要在未来研究中进一步验证。
