Shengli Clinical College of Fujian Medical University, Fuzhou, China.
Department of Orthopedic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
Medicine (Baltimore). 2023 Aug 25;102(34):e34705. doi: 10.1097/MD.0000000000034705.
To evaluate the clinical efficacy and prognosis of unilateral biportal endoscopic lumbar fusion (ULIF) and minimally invasive transforaminal lumbar fusion (MIS-TLIF) for lumbar degenerative diseases.
Chinese and English databases were retrieved for the period from database creation to December 31, 2022. Case-control studies on unilateral biportal endoscopic lumbar fusion were collected. The observation indexes consisted of operation times, intraoperative blood loss, postoperative drainage volume, length of hospital stay, postoperative pain score, postoperative oswestry disability index score, postoperative MacNab excellent and good rate, imaging fusion rate at the last follow-up, and complications. The NO rating table was employed to assess the quality of the included literature, and a meta-analysis was conducted using Revman5.4.1 and Stata17.
Ten studies with 738 surgical patients were considered, including 347 patients in the ULIF group and 391 in the MIS-TLIF group. This Meta-analysis demonstrated statistically significant differences in mean operation duration, intraoperative blood loss, postoperative drainage volume, length of hospital stay, and early postoperative (1-2W) visual analogue scale/score (VAS) scores for back pain. No significant differences were observed in the final follow-up postoperative VAS scores for back pain, postoperative leg VAS score, postoperative oswestry disability index score, excellent and good rate of postoperative modified MacNab, imaging fusion rate, and complications.
Compared with the MIS-TLIF group, the ULIF group had longer operation time, lower intraoperative blood loss and postoperative drainage volume, lower lumbar VAS score in the early postoperative period, and shorter hospital stay. ULIF is less invasive than traditional MIS-TLIF, making it a trustworthy surgical option for lumbar degenerative diseases with comparable fusion efficiency, superior MacNab rate, and complication rate.
评价单边双通道内镜下腰椎融合术（ULIF）与微创经椎间孔腰椎融合术（MIS-TLIF）治疗腰椎退变性疾病的临床疗效和预后。
检索建库至 2022 年 12 月 31 日的中文和英文数据库，收集单侧双通道内镜下腰椎融合术的病例对照研究，观察指标包括手术时间、术中出血量、术后引流量、住院时间、术后疼痛评分、术后 Oswestry 功能障碍指数评分、术后 MacNab 优良率、末次随访时影像学融合率及并发症。采用纽卡斯尔-渥太华量表（NOS）评价纳入文献质量，采用 Revman5.4.1 和 Stata17 进行 Meta 分析。
纳入 10 项研究，共 738 例手术患者，ULIF 组 347 例，MIS-TLIF 组 391 例。Meta 分析显示，两组手术时间、术中出血量、术后引流量、住院时间、术后早期（1-2 周）腰痛视觉模拟评分/量表（VAS）评分差异均有统计学意义，末次随访时腰痛 VAS 评分、术后腿痛 VAS 评分、术后 Oswestry 功能障碍指数评分、术后改良 MacNab 优良率、影像学融合率、并发症发生率差异均无统计学意义。
与 MIS-TLIF 组相比，ULIF 组手术时间长，术中出血量、术后引流量少，术后早期腰痛 VAS 评分低，住院时间短。ULIF 较传统 MIS-TLIF 具有微创优势，融合效率相当，MacNab 优良率、并发症发生率较高，是腰椎退变性疾病安全可靠的手术选择。
