Comparing Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion in Obese and Nonobese Patients: A Systematic Review and Meta-Analysis

Abstract

Background: Our study aimed to compare the outcomes of obese and nonobese patients following minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).Methods: Relevant studies comparing the outcome of MIS-TLIF between obese and nonobese patients were involved to make a systematic literature review and meta-analysis. All of the comparative studies published in PubMed, MEDLINE, and Web of Science databases as recently as 10 July 2020, were included. Primary outcomes (complications) and secondary outcomes (Oswestry Disability Index (ODI) score, visual analog scale (VAS) score, the length of hospital stay, the duration of surgery, and the estimated blood loss) were assessed between obese patients and nonobese patients. Statistical analysis was performed by Review Manager 5.3 and forest plots were made for each outcome.Results: Nine studies were enrolled in this meta-analysis. BMI correlated significantly with complications, and postoperative complications occurred more frequently in obese patients. Additionally, obese patients after MIS-TLIF were associated with similar Oswestry Disability Index (ODI) score, Visual Analog Scale score for back pain(BP-VAS), and Visual Analog Scale score for leg pain(LP-VAS) scores in early (≤6 months after MIS-TLIF) and late period (≥24 months after MIS-TLIF). There was no significant difference in intraoperative complications, duration of surgery, length of hospital stay, and estimated blood loss between the two groups.Conclusion: Obese patients should not be excluded from MIS-TLIF procedures due to worry about higher postoperative complication rates. Understanding common postoperative complications after MIS-TLIF will improve the treatment of obese patients with the degenerative lumbar disease.