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单侧双通道内镜下腰椎间融合术与微创经椎间孔腰椎间融合术治疗单节段腰椎退变性疾病的Meta 分析。

Unilateral biportal endoscopic lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion for single-segment lumbar degenerative disease: a meta-analysis.

机构信息

Department of Orthopaedics, Ninth Hospital of Xi'an, 151 East Section of South Second Ring Road, Xi'an, 710054, China.

出版信息

BMC Musculoskelet Disord. 2024 Nov 21;25(1):938. doi: 10.1186/s12891-024-08046-0.

Abstract

BACKGROUND

Minimally invasive spine surgery has seen rapid development in recent years. The purpose of this study was to evaluate the use of unilateral biportal endoscopic lumbar interbody fusion (ULIF) versus minimally invasive surgery transforaminal interbody fusion (MIS-TLIF) for the treatment of single-segment lumbar degenerative disease (LDD) through a systematic review and meta-analysis.

METHODS

In collaboration with various search terms, a comprehensive examination of the scientific literature was carried out using PubMed, China National Knowledge Infrastructure (CNKI), Wanfang, and other databases. A total of 9 studies were included retrospective cohort studies.

RESULTS

We observed statistically significant differences in intraoperative blood loss, total hospital stay, postoperative hospital stays, and 1-month postoperative Oswestry Disability Index (ODI) scores between the ULIF and MIS-TLIF groups, with the ULIF group being more dominant. MIS-TLIF group was statistically more advantageous in terms of operative time. There were no statistically significant differences in postoperative visual analogue scale (VAS) scores, 3-month postoperative and final ODI scores, excellent and good rate, complications, disc heights, and lumbar lordosis angle between the two groups.

CONCLUSIONS

Treatment of single-segment LDD with ULIF and MIS-TLIF is both safe and effective. ULIF has the advantage of less intraoperative blood loss, shorter total hospital stay, shorter postoperative hospital stay, and lower ODI scores at 1 month postoperatively compared to MIS-TLIF. There were no significant differences between ULIF and MIS-TLIF in the treatment of LDD in terms of postoperative VAS scores, 3-month postoperative and final ODI scores, satisfaction rates, fusion rates, complications, disc heights, and lumbar lordosis angle. MIS-TLIF has a shorter procedure time than ULIF.

摘要

背景

近年来,微创脊柱外科发展迅速。本研究旨在通过系统评价和荟萃分析评估单侧双通道内镜下腰椎间融合术(ULIF)与微创经椎间孔腰椎间融合术(MIS-TLIF)治疗单节段腰椎退行性疾病(LDD)的效果。

方法

本研究通过联合使用各种检索词,对 PubMed、中国知网(CNKI)、万方等数据库进行全面的文献检索。共纳入 9 项回顾性队列研究。

结果

我们发现 ULIF 组与 MIS-TLIF 组在术中出血量、总住院时间、术后住院时间和术后 1 个月 Oswestry 功能障碍指数(ODI)评分方面存在统计学差异,ULIF 组具有优势。在手术时间方面,MIS-TLIF 组具有统计学优势。两组术后视觉模拟评分(VAS)评分、术后 3 个月和末次 ODI 评分、优良率、并发症、椎间盘高度和腰椎前凸角无统计学差异。

结论

采用 ULIF 和 MIS-TLIF 治疗单节段 LDD 均安全有效。与 MIS-TLIF 相比,ULIF 具有术中出血量少、总住院时间短、术后住院时间短、术后 1 个月 ODI 评分低的优势。在治疗 LDD 方面,ULIF 与 MIS-TLIF 在术后 VAS 评分、术后 3 个月和末次 ODI 评分、满意度、融合率、并发症、椎间盘高度和腰椎前凸角方面无显著差异。MIS-TLIF 的手术时间短于 ULIF。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2edb/11580209/c7297104e65b/12891_2024_8046_Fig1_HTML.jpg

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