Hu Qianqin, Xiao Keyi, Nan Jin-Niang, Jhang Shang-Wun, Chen Chien-Min, Lin Guang-Xun
First Department of Orthopedics, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, People's Republic of China.
The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
J Pain Res. 2025 Apr 26;18:2215-2231. doi: 10.2147/JPR.S472975. eCollection 2025.
To effectuate a comprehensive juxtaposition of the clinical implications, incidence of complications, and successful fusion rates observed in the context of biportal endoscopic lumbar interbody fusion (BE-LIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).
The present research initiative involved an exhaustive exploration of pertinent scholarly literature in renowned databases, which lasted until April 2023. The evaluative framework encompassed a diverse array of parameters, including but not limited to operation time, hospitalization, quantification of estimated blood loss, the assessment of outcomes via the application of the Visual Analog Scale (VAS) to gauge pain intensity, and the utilization of the Oswestry Disability Index (ODI) to measure functional impairment.
The current meta-analysis included ten studies with a total of 736 participants. In comparison of the BE-LIF and MI-TLIF techniques, no substantial differences were observed in the parameters studied, included VAS for leg pain (P > 0.05), as well as the assessment of complication rates (7.76% versus 7.97%; P = 0.71) and fusion rates (89.59% versus 88.60%; P = 0.90). However, the early postoperative VAS for back pain (P < 0.0001) and the early postoperative ODI score (P = 0.007) were significantly lower in the BE-LIF group than in the MI-TLIF group. Additionally, a significant difference in blood loss was observed (P < 0.0001), with less blood loss in the BE-LIF group compared to the MI-TLIF group. Furthermore, the complex surgical procedure of BE-LIF resulted in a longer duration of surgery (P = 0.02) but shorter hospitalization compared with MI-TLIF (P < 0.0001).
Within the context of the management of lumbar degenerative diseases, BE-LIF surgery exhibits clinical effectiveness and incidence of complications comparable to MI-TLIF. In contrast to MI-TLIF, BE-LIF offers distinctive merits, including reduced blood loss, abbreviated hospitalization durations, expedited relief from postoperative back pain, and an accelerated trajectory towards functional recuperation.
全面对比双门内镜下腰椎椎间融合术（BE-LIF）和微创经椎间孔腰椎椎间融合术（MI-TLIF）的临床意义、并发症发生率及融合成功率。
本研究对知名数据库中截至2023年4月的相关学术文献进行了详尽的检索。评估框架涵盖了一系列不同参数，包括但不限于手术时间、住院时间、估计失血量的量化、通过视觉模拟量表（VAS）评估疼痛强度的结果，以及利用奥斯威斯利残疾指数（ODI）测量功能障碍。
当前的荟萃分析纳入了10项研究，共736名参与者。对比BE-LIF和MI-TLIF技术，在所研究的参数中未观察到显著差异，包括腿痛的VAS评分（P>0.05），以及并发症发生率（7.76%对7.97%；P=0.71）和融合率（89.59%对88.60%；P=0.90）。然而，BE-LIF组术后早期背痛的VAS评分（P<0.0001）和术后早期ODI评分（P=0.007）显著低于MI-TLIF组。此外，观察到失血量存在显著差异（P<0.0001），BE-LIF组的失血量少于MI-TLIF组。此外，BE-LIF复杂的手术操作导致手术时间更长（P=0.02），但与MI-TLIF相比住院时间更短（P<0.0001）。
在腰椎退行性疾病的治疗中，BE-LIF手术的临床疗效和并发症发生率与MI-TLIF相当。与MI-TLIF相比，BE-LIF具有独特优势，包括减少失血量、缩短住院时间、更快缓解术后背痛以及加速功能恢复进程。
