A Meta-analysis: clinical efficacy and safety of TLIF versus PLIF for the treatment of mild-moderate degenerative lumbar spondylolisthesis

English Keywords:Lumbar fusion  Transforaminal lumbar interbody fusion(TLIF)  Posterior lumbar interbody fusion(PLIF)  Lumbar spondylolisthesis  Meta-analysis

English Abstract:

  【Abstract】 Objectives: Comprehensive evaluation of the clinical efficacy and safety of transforaminal lumbar interbody fusion(TLIF) and posterior lumbar interbody fusion with pedide(PLIF) screw fixation for the treatment of degenerative lumbar spondylollsthesis(DLS), to provide evidence for clinical procedure. Methods: Databases including CNKI, CBM, Wanfang Database, PubMed, the Cochrane Library, Elsevier ScienceDirect(SDOS) were searched for studies of TLIF versus PLIF for degenerative lumbar spondylolisthesis from the inception respectively to August 2017. Included studies contain at least the following indicators: operation time, intraoperative blood loss, fusions, visual analogue score(VAS), Oswestry disability index(ODI), complications, disc space height, reoperations. Review Manager 5.3 software was used for data analysis. Results: Two randomized controlled trials(RCT) and eight cohort studies including 757 patients were included in the meta-analysis: 386 patients in TLIF group, 371 patients in PLIF group. The results of meta-analysis showed that there were statistical differences in operation time(P<0.05), intraoperative blood loss(P<0.05) and complications(P<0.05) between two groups. There were no statistical differences in VAS(P=0.18), ODI(P=0.27), fusions(P=0.80), disc space height(P=0.97) and reoperations(P=0.29). Conclusion: Two different methods have no statistical difference in VAS, ODI, fusions, disc space height. They have similar clinical efficacy. And, TLIF have less operation time, intraoperative blood loss, and complications than PLIF, TLIF safer than PLIF.