Wiltse approach versus the conventional posterior midline approach for lumbar degenerative diseases: a metaanalysis / 中南大学学报(医学版)

ABSTRACT

OBJECTIVE@#To systematically evaluate the effectiveness and safety of transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) for lumbar degenerative diseases (LDD).@*METHODS@#Databases including Th e Cochrane Library, PubMed, EMbase,MEDLINE, SCI, CNKI, CBM, WanFang Data were searched to collect the randomized controlled trails (RCTs) and non-RCTs regarding TLIF versus PLIF for LDD. The retrieval time was from early available time to February 2014. The search was followed the inclusion and exclusion criteria. The data were collected and evaluated by 2 reviewers independently. The Meta analysis was conducted by using RevMan 5.2 software.@*RESULTS@#A total of 7 RCTs and 8 non-RCTs involving 1 127 patients were included. The results of Meta-analysis showed that there were significant difference in visual analog score (VAS) [MD=-0.54, 95% CI (-0.79, -0.29), P<0.001], Oswestry disability index (ODI) [MD=-4.20, 95%CI (-6.16, -2.25), P<0.001], intraoperative blood [MD=-170.98, 95% CI (-225.10, -116.85), P< 0.001], duration of operation [MD=3.18, 95% CI (-8.21, 14.56), P=0.58] and Hospital stays [MD=-3.08, 95% CI (-3.03, -1.57), P=0.0003] between the PLIF and Wiltse- TLIF groups.@*CONCLUSION@#Wiltse-TLIF is superior to PLIF in treating LDD, with less operative blood loss, shorter hospital stays and lower postoperative complications. Thus, Wiltse-TLIF is safe and feasible for treating LDD as the indications are under strict control.