title: Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence.
abstract: OBJECTIVE
  This is a meta-analysis of randomized and non-randomized studies comparing the clinical and radiological efficacy of minimally invasive (MI) and conventional open transforaminal lumbar interbody fusion (open-TLIF) for degenerative lumbar diseases.
  
  
  METHODS
  A literature search of the MEDLINE database identified 11 studies that met our inclusion criteria. A total of 785 patients were examined. Pooled estimates of clinical and radiological outcomes, and corresponding 95% confidence intervals were calculated.
  
  
  RESULTS
  The pooled data revealed that MI-TLIF was associated with less blood loss, shorter hospital stay, and a trend of better functional outcomes when compared with open-TLIF. However, MI-TLIF significantly increased the intraoperative X-ray exposure. Both techniques had similar operative time, complication rate, and re-operation rate.
  
  
  CONCLUSIONS
  Based on the available evidence, MI-TLIF for degenerative lumbar diseases might lead to better patient-based outcomes. MI-TLIF would be a promising procedure, but extra efforts are needed to reduce its intraoperative radiation exposure. More randomized controlled trials are needed to compare these two surgical options.
authors.affiliation: From Zhejiang Spine Research Center, Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuanxi Road, Wenzhou, Zhejiang 325000, China.
authors.forename: Nai-Feng
authors.initials: NF
authors.lastname: Tian
authors.forename: Yao-Sen
authors.initials: YS
authors.lastname: Wu
authors.forename: Xiao-Lei
authors.initials: XL
authors.lastname: Zhang
authors.forename: Hua-Zi
authors.initials: HZ
authors.lastname: Xu
authors.forename: Yong-Long
authors.initials: YL
authors.lastname: Chi
authors.forename: Fang-Min
authors.initials: FM
authors.lastname: Mao
mesh_terms: D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000601:surgery*; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D017063:Outcome Assessment, Health Care; D011859:Radiography; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome