Lumbar degenerative disease treated by percutaneous endoscopic transforaminal lumbar interbody fusion or minimally invasive surgery-transforaminal lumbar interbody fusion: a case-matched comparative study

Abstract

Purpose This study aimed to evaluate the clinical efficacy and imaging results of percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) through comparing it with minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF). Materials and methods We performed a retrospective analysis on patients with lumbar degenerative disease treated by PETLIF or MISTLIF from September 2017 to January 2019, and the patients were divided into two groups: the PETLIF group and the MISTLIF group. The clinical and imaging parameters of the two groups were evaluated. Results There was no significant difference between the two groups in operative time and complication rate. The estimated blood loss and the length of hospital stay in the PETLIF group were significantly better than those in the MISTLIF group. Compared with those before operation, the postoperative VAS-L and VAS-B scores were significantly improved after operation in the both groups. In addition, the postoperative VAS-B score of the PETLIF group was significantly lower than that of the MISTLIF group. At the last follow-up, there was no significant difference between the two groups in the VAS-L score, VAS-B score, ODI score, and bony fusion rate. Conclusions Both PETLIF and MISTLIF could achieve satisfactory clinical outcomes in the treatment of lumbar degenerative disease, but our study suggested that PETLIF had less damage, rapid recovery after operation, and short discharge time.

Percutaneous endoscopic versus minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative diseases: a meta-analysis.

“…After step-by-step selection, a total of 8 studies were eligible for analysis (Figure 1, Table I). Seven studies were retrospective [12][13][14][15][16][17][18], and 1 study was prospective [11]. Seven studies were from China [11,12,[14][15][16][17][18], and 1 study was from South Korea [13].…”

“…Seven studies were retrospective [12][13][14][15][16][17][18], and 1 study was prospective [11]. Seven studies were from China [11,12,[14][15][16][17][18], and 1 study was from South Korea [13].…”

“…Seven studies reported on the intra-operative blood loss [11,12,[14][15][16][17][18]. The pooled intra-operative blood loss is drastically lower in the PE-TLIF group than in the MIS-TLIF group (MD = -77.48; 95% CI: -127.05-27.92; p = 0.002, Figure 2 H).…”

“…To overcome MIS-TLIF shortcomings, percutaneous endoscopic TLIF (PE-TLIF) has been commonly used for patients with LDD [11][12][13]. PE-TLIF makes possible a complete endoscopic discectomy, spinal canal and foramina decompression, and interbody fusion via the endoscopic and working portal [14][15][16][17]. Although numerous earlier investigations explored the relative efficacies of PE-TLIF and MIS-TLIF in treating LDD [11][12][13][14][15][16][17][18], most of these studies were retrospective in nature.…”

“…PE-TLIF makes possible a complete endoscopic discectomy, spinal canal and foramina decompression, and interbody fusion via the endoscopic and working portal [14][15][16][17]. Although numerous earlier investigations explored the relative efficacies of PE-TLIF and MIS-TLIF in treating LDD [11][12][13][14][15][16][17][18], most of these studies were retrospective in nature. Since multiple factors can sway the outcomes of a retrospective investigation, and introduce unintentional bias, a meta-analysis is recommended to extensively evaluate relevant literature, reduce bias risk, and enhance the overall statistical power of the collective study outcomes.…”