Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
Clin Spine Surg. 2021 Dec 1;34(10):395-405. doi: 10.1097/BSD.0000000000001107.
This is a meta-analysis and systematic review of the available literature.
This study aims to compare the clinical and radiologic outcomes of single-level lateral lumbar interbody fusion (LLIF) with single-level transforaminal lumbar interbody fusion (TLIF).
In the treatment of adult spinal deformity, LLIF allows interbody fusion while avoiding complications associated with an anterior or transforaminal approach, although the clinical outcomes of LLIF compared with other approaches have not been well established.
We searched PubMed, Embase, and Scopus for 385 unique studies. On the basis of our exclusion criteria, 8 studies remained for our systematic review. Data were analyzed using Review Manager 5.3 using Mantel-Haenszel statistics and random effect models. This study identified self-reported Visual Analog Scale (VAS), Oswestry Disability Index, length of stay, blood loss, complication rate, and radiologic parameters (disk height, lumbar lordosis, segmental lordosis).
Our meta-analysis showed that LLIF contributed to decreased blood loss [mean difference (MD)=-67.62 mL, 95% confidence interval (CI): -104 to -30.90, P<0.001], superior restoration of segmental lordosis (MD=1.91 degrees, 95% CI: 0.71-3.10, P=0.002), lumbar lordosis (MD=1.95 degrees, 95% CI: 0.15-3.74, P=0.03), and disk height (MD=2.18 mm, 95% CI: 1.18-3.17, P<0.001) when compared with TLIF. However, current data suggests no significant difference in clinical outcomes between LLIF and TLIF based on overall complication rates (P=0.22), length of hospital stay (P=0.65), postoperative Oswestry Disability Index (P=0.13), postoperative VAS Back Pain (P=0.47) and VAS Leg Pain (P=0.16).
LLIF is an increasingly popular option for single-level anterior column reconstruction. When compared with single-level TLIF, single-level LLIF is associated with greater changes in lumbar lordosis and disk height. The single-level LLIF is a viable alternative to TLIF, demonstrating comparable clinical outcomes and better restoration of spinopelvic parameters.
Level III.
这是一项对现有文献进行的荟萃分析和系统评价。
本研究旨在比较单节段侧方腰椎间融合术（LLIF）与单节段经椎间孔腰椎间融合术（TLIF）的临床和影像学结果。
在成人脊柱畸形的治疗中，LLIF 允许椎间融合，同时避免与前路或经椎间孔入路相关的并发症，尽管其与其他入路相比的临床结果尚未得到充分确立。
我们在 PubMed、Embase 和 Scopus 中搜索了 385 篇独特的研究。根据我们的排除标准，有 8 项研究纳入了我们的系统评价。使用 Review Manager 5.3 软件采用 Mantel-Haenszel 统计和随机效应模型进行数据分析。本研究采用自报告视觉模拟量表（VAS）、Oswestry 残疾指数、住院时间、出血量、并发症发生率和影像学参数（椎间盘高度、腰椎前凸角、节段前凸角）来评估结果。
我们的荟萃分析显示，LLIF 有助于减少出血量[平均差值（MD）=-67.62ml，95%置信区间（CI）：-104 至-30.90，P<0.001]，更好地恢复节段前凸角（MD=1.91 度，95%CI：0.71-3.10，P=0.002）、腰椎前凸角（MD=1.95 度，95%CI：0.15-3.74，P=0.03）和椎间盘高度（MD=2.18mm，95%CI：1.18-3.17，P<0.001），与 TLIF 相比。然而，根据总体并发症发生率（P=0.22）、住院时间（P=0.65）、术后 Oswestry 残疾指数（P=0.13）、术后 VAS 腰痛（P=0.47）和 VAS 腿痛（P=0.16），目前的数据表明 LLIF 和 TLIF 的临床结果无显著差异。
LLIF 是一种越来越受欢迎的单节段前柱重建选择。与单节段 TLIF 相比，单节段 LLIF 与更大的腰椎前凸角和椎间盘高度变化相关。单节段 LLIF 是 TLIF 的可行替代方法，具有相似的临床结果和更好的脊柱骨盆参数恢复。
III 级。
