Department of Spine Surgery, The Six Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
J Orthop Surg Res. 2023 Nov 22;18(1):888. doi: 10.1186/s13018-023-04393-1.
To compare the efficacy and safety of unilateral biportal endoscopic transforaminal lumbar interbody fusion (BE-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in lumbar degenerative diseases.
This study was registered on International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023432460). We searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wan Fang Database, and Wei Pu Database by computer to collect controlled clinical studies on the efficacy and safety of unilateral BE-TLIF and MIS-TLIF in lumbar degenerative diseases from database establishment to May 2023. Two researchers screened the literature, extracted data and evaluated the risk of bias of the included studies, recorded the authors, and sample size, and extracted the intraoperative blood loss, operation time, postoperative drainage, Oswestry disability index, Visual analogue scale, lumbar lordosis, disk height, hospital length stay, fusion rate, and complications in each study. Meta-analysis was performed using Revman 5.4 software provided by Cochrane Library.
A total of 14 cohort studies with a total of 1007 patients were included in this study, including 472 patients in the BE-TLIF group and 535 patients in the MIS-TLIF group. The BE-TLIF group had lower intraoperative blood loss than the MIS-TLIF group [mean difference (MD) = - 78.72, 95% CI (- 98.47, - 58.97), P < 0.00001] and significantly reduced postoperative drainage than the MIS-TLIF group [MD = - 43.20, 95% CI (- 56.57, - 29.83), P < 0.00001], and the operation time was longer than that of the MIS-TLIF group [MD = 22.68, 95% CI (12.03, 33.33), P < 0.0001]. Hospital length stay in BE-TLIF group was significantly less than that in MIS-TLIF group [MD = - 1.20, 95% CI (- 1.82, - 0.57), P = 0.0002].
Compared with MIS-TLIF, BE-TLIF for lumbar degenerative diseases has the advantages of less intraoperative blood loss, less early postoperative low back and leg pain, shorter postoperative hospital length stay, and faster early functional recovery.
比较单侧双通道内镜经椎间孔腰椎间融合术（BE-TLIF）与微创经椎间孔腰椎间融合术（MIS-TLIF）治疗腰椎退行性疾病的疗效和安全性。
本研究已在国际前瞻性系统评价注册库（PROSPERO）（ID：CRD42023432460）中注册。我们通过计算机检索PubMed、Embase、Web of Science、Cochrane 图书馆、中国知网、万方数据库和维普数据库，收集从数据库建立到 2023 年 5 月关于单侧 BE-TLIF 和 MIS-TLIF 治疗腰椎退行性疾病的疗效和安全性的对照临床试验。由 2 名研究人员筛选文献、提取数据并评估纳入研究的偏倚风险，记录作者和样本量，并提取每项研究中的术中出血量、手术时间、术后引流、Oswestry 功能障碍指数、视觉模拟评分、腰椎前凸角、椎间盘高度、住院时间、融合率和并发症。使用 Cochrane 图书馆提供的 Revman 5.4 软件进行 Meta 分析。
本研究共纳入 14 项队列研究，共 1007 例患者，其中 BE-TLIF 组 472 例，MIS-TLIF 组 535 例。BE-TLIF 组术中出血量少于 MIS-TLIF 组[均数差（MD）= -78.72，95%置信区间（CI）（-98.47，-58.97），P<0.00001]，术后引流少于 MIS-TLIF 组[MD= -43.20，95% CI（-56.57，-29.83），P<0.00001]，手术时间长于 MIS-TLIF 组[MD= 22.68，95% CI（12.03，33.33），P<0.0001]。BE-TLIF 组的住院时间明显短于 MIS-TLIF 组[MD= -1.20，95% CI（-1.82，-0.57），P=0.0002]。
与 MIS-TLIF 相比，用于腰椎退行性疾病的 BE-TLIF 具有术中出血量少、术后早期腰痛和腿痛少、术后住院时间短、早期功能恢复快的优点。
