■目前关于斜腰椎椎间融合术(OLIF)和经椎间孔腰椎椎间融合术(TLIF)治疗腰椎退行性疾病的疗效存在一定争议。
■本研究通过文献回顾和荟萃分析,比较了OLIF和TLIF在腰椎退行性疾病中的应用效果。
■我们纳入了比较TLIF和OLIF治疗腰椎退行性疾病的随机对照试验和队列研究。我们搜索了诸如“椎间盘退变,\"\"脊柱融合术,PubMed中的“和”腰椎“,Embase,和Cochrane图书馆数据库。搜索日期从数据库的建立日期到2023年10月。两位作者独立进行文献筛选,数据抽象,和定性评估。采用RevMan5.3软件进行荟萃分析。赔率比(OR),加权平均差(WMD),95%CI采用固定效应模型(FEM)或随机效应模型(REM)计算。
■共有18项队列研究纳入1,550名患者,其中806例患者接受TLIF(TLIF组),744例患者接受OLIF(OLIF组).融合率差异无统计学意义[OR=1.58(0.95,2.64),P=0.08],并发症发生率[OR=1.25(0.93,1.68),P=0.14],和背痛视觉模拟量表(VAS-BP)[WMD=0.00(-0.13,0.14),两组间P=0.96。与TLIF组相比,OLIF组的Oswestry残疾指数(ODI)较低[WMD=-0.62(-1.03,-0.20),P=0.003],较高的孔高度(FH)[WMD=2.03(1.42,2.46),P<0.001],较高的光盘高度(DH)[WMD=1.69(1.17,2.22),P<0.001],和较短的停留时间(LOS)[WMD=-1.80(-2.55,-1.05),P<0.001]。
■在腰椎退行性疾病的治疗中,与TLIF相比,OLIF在改善腰椎功能方面更具优势,恢复FH和DH,缩短LOS。两种方法都有相当的融合率,并发症发生率,和腰椎疼痛的改善。由于研究量小,对偏差风险的评估不清楚,高品质,需要大样本随机对照研究来证明这一点。
UNASSIGNED: There currently exists some controversy about the efficacy of oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar degenerative diseases.
UNASSIGNED: This study compares the application effects of OLIF and TLIF in lumbar degenerative diseases by reviewing the literature and using meta-analysis.
UNASSIGNED: We included randomized controlled trials and cohort studies comparing TLIF and OLIF in the treatment of lumbar degenerative diseases. We searched for words such as \"intervertebral disc degeneration,\" \"spinal fusion,\" and \"lumbar vertebrae\" in the PubMed, Embase, and Cochrane Library databases. The search date was set from the establishment date of the database to October 2023. Two authors independently conducted document screening, data abstraction, and qualitative assessment. A meta-analysis was performed and adapted to RevMan5.3 software. The odds ratio (OR), weighted mean difference (WMD), and 95% CI were calculated by adopting a fixed-effect model (FEM) or a random-effect model (REM).
UNASSIGNED: A total of 18 cohort studies were included with 1,550 patients, of whom 806 patients underwent TLIF (TLIF group) and 744 patients underwent OLIF (OLIF group). There were no significant differences found in the fusion rate [OR = 1.58 (0.95, 2.64), P = 0.08], complication rate [OR = 1.25 (0.93, 1.68), P = 0.14], and visual analog scale for back pain (VAS-BP) [WMD = 0.00 (-0.13, 0.14), P = 0.96] between the two groups. Compared with the TLIF group, the OLIF group had a lower Oswestry disability index (ODI) [WMD = -0.62 (-1.03, -0.20), P = 0.003], a higher foramen height (FH) [WMD = 2.03 (1.42, 2.46), P < 0.001], a higher disc height (DH) [WMD = 1.69 (1.17, 2.22), P < 0.001], and a shorter length of stay (LOS) [WMD = -1.80 (-2.55, -1.05), P < 0.001].
UNASSIGNED: In the treatment of lumbar degenerative diseases, compared with TLIF, OLIF has more advantages in terms of improving the lumbar function, restoring the FH and DH, and shortening the LOS. Both methods have comparable fusion rates, complication rates, and lumbar pain improvements. Due to the small amount of research and unclear assessment of the risk of bias, high-quality, large-sample randomized controlled studies are required to prove it.