Kou Yuanqiao, Chang Jianjun, Guan Xiaoming, Chang Qiang, Feng Haoyu
The Third Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Spinal Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, Shanxi, China.
World Neurosurg. 2021 Aug;152:e352-e368. doi: 10.1016/j.wneu.2021.05.109. Epub 2021 Jun 1.
To compare clinical efficacy and safety of endoscopic lumbar interbody fusion (Endo-LIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in treatment of lumbar degenerative diseases.
A literature search was performed using PubMed, Embase, Web of Science, and Cochrane Library databases. Studies published up to November 15, 2020, that compared Endo-LIF with MIS-TLIF for treating lumbar degenerative diseases were retrieved. Data were extracted according to predefined clinical outcome measures. Primary outcomes were preoperative and postoperative visual analog scale for leg and back pain and Oswestry Disability Index scores. Secondary outcomes were operative time and intraoperative blood loss; length of hospitalization; and complication, reoperation, and fusion rates. Data analysis was conducted with statistical software.
The meta-analysis included 6 studies comprising 480 patients. Results of the merged analysis revealed similar complication, reoperation, and fusion rates and preoperative and postoperative visual analog scale for leg and back pain and Oswestry Disability Index scores (P > 0.05) for Endo-LIF and MIS-TLIF. Nevertheless, with the exception of longer operative time (P < 0.05), Endo-LIF compared favorably with MIS-TLIF, with less intraoperative blood loss, shorter hospital stay (P < 0.05), and better long-term functional outcome.
Based on the evidence provided by this study, there is no significant difference in clinical efficacy and safety between Endo-LIF and MIS-TLIF in the treatment of lumbar degenerative diseases. Although Endo-LIF has a longer operative time, it has the advantages of less tissue trauma and rapid recovery after operation.
比较内镜下腰椎椎间融合术（Endo-LIF）与微创经椎间孔腰椎椎间融合术（MIS-TLIF）治疗腰椎退行性疾病的临床疗效和安全性。
使用PubMed、Embase、Web of Science和Cochrane图书馆数据库进行文献检索。检索截至2020年11月15日发表的比较Endo-LIF与MIS-TLIF治疗腰椎退行性疾病的研究。根据预先定义的临床结局指标提取数据。主要结局指标为术前和术后腿部及背部疼痛的视觉模拟评分以及Oswestry功能障碍指数评分。次要结局指标为手术时间、术中出血量、住院时间、并发症、再次手术率和融合率。使用统计软件进行数据分析。
荟萃分析纳入6项研究，共480例患者。合并分析结果显示，Endo-LIF和MIS-TLIF在并发症、再次手术率和融合率以及术前和术后腿部及背部疼痛的视觉模拟评分和Oswestry功能障碍指数评分方面相似（P>0.05）。然而，除了手术时间较长外（P<0.05），Endo-LIF与MIS-TLIF相比具有优势，术中出血量更少、住院时间更短（P<0.05）以及长期功能结局更好。
基于本研究提供的证据，Endo-LIF和MIS-TLIF在治疗腰椎退行性疾病的临床疗效和安全性方面无显著差异。虽然Endo-LIF手术时间较长，但具有组织创伤小、术后恢复快的优点。
