Meta-analysis of clinical effects of transforaminal lumbar interbody fusion versus posterior lumbar interbody fusion on lumbar spondylolisthesis and lumbar instability in Chinese population / 中华老年医学杂志

ABSTRACT

Objective To evaluate the clinical effects of transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) on lumbar spondylolisthesis and lumbar instability in Chinese patients.Methods Literatures about clinical effects of TLIF and PLIT on lumbar spondylolisthesis and lumbar instability were collected from Chinese academic literature database (CNKI),Chinese biomedical literature database (CMBdisc),Wanfang database and Chinese journals of orthopedics.Data from those literatures including operation time,bleeding volume,surgical complications,postoperative interspace height,visual analog scale (VAS) score,Oswestry Disability Index (ODI) and improvement rate of Japanese Orthopedic Association (JOA) score were analyzed by Stata SE 11.2 software.Results A total of 12 literatures met the inclusion criteria and 1041 cases were included (PLIF group,n=520; PLIF group,n=521).The operation time was longer in PLIF group than in TLIF group [standardized mean difference (SMD)=1.26,95％CI0.58-1.94,P＜0.001].The bleeding volume was more in PLIF group than in TLIF group SMD=1.70,95％CI0.94 2.46,P＜0.001).The surgical complications were more in PLIF group than in TLIF group (SMD=4.50,95％CI2.65-7.64,P＜0.001).There were no statistical differences in postoperative interspace height,VAS score,ODI score,improvement rate of JOA score and fusion rate between the two groups [SMD=-0.07,-0.07,0.15,1.43,95％CI-0.44-0.30,-0.27-0.13,-0.06-0.35,0.75-2.73,0.63-2.15,respectively,all P＞0.05].Conclusions TLIF has significant advantages on decreasing operation time,bleeding volume and risk of surgical complications as compared with PLIF.TLIF and PLIF have the same clinical efficacy on restoring and maintaining postoperative interspace height.