The Outcomes of Minimally Invasive versus Open Posterior Approach Spinal Fusion in Treatment of Lumbar Spondylolisthesis: The Current Evidence from Prospective Comparative Studies.
Purpose. To investigate the evidence of minimally invasive (MI) versus open (OP) posterior lumbar fusion in treatment of lumbar spondylolisthesis from current prospective literatures.Methods. The electronic literature database of Pubmed, Embase, and Cochrane library was searched at April 2016. The data of operative time, estimated blood loss and length of hospital stay, visual analog scale (VAS) of both lower back pain and leg pain, Oswestry disability index (ODI), SF-36 PCS (physical component scores) and SF-36 MCS (mental component scores), complications, fusion rate, and secondary surgery were extracted and analyzed by STATA 12.0 software.Results. Five nonrandom prospective comparative studies were included in this meta-analysis. The meta-analysis showed that the MI group had a significantly longer operative time than OP group, less blood loss, and shorter hospital stay. No significant difference was found in back pain, leg pain, ODI, SF-36 PCS, SF-36 MCS, complications, fusion rate, and secondary surgery between MI and OP groups.Conclusion. The prospective evidence suggested that MI posterior fusion for spondylolisthesis had less EBL and hospital stay than OP fusion; however it took more operative time. Both MI and OP fusion had similar results in pain and functional outcomes, complication, fusion rate, and secondary surgery.
Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical University, Second Medical College of Wenzhou Medical University, Zhejiang Spine Center, Wenzhou, Zhejiang, China.
Ai-Min
AM
Wu
Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical University, Second Medical College of Wenzhou Medical University, Zhejiang Spine Center, Wenzhou, Zhejiang, China.
Chun-Hui
CH
Chen
Department of Orthopedics, Hainan Medical College, Haikou, Hainan, China.
Zhi-Hao
ZH
Shen
Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical University, Second Medical College of Wenzhou Medical University, Zhejiang Spine Center, Wenzhou, Zhejiang, China.
Zhen-Hua
ZH
Feng
Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical University, Second Medical College of Wenzhou Medical University, Zhejiang Spine Center, Wenzhou, Zhejiang, China.
Wan-Qing
WQ
Weng
Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical University, Second Medical College of Wenzhou Medical University, Zhejiang Spine Center, Wenzhou, Zhejiang, China.
Shu-Min
SM
Li
Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical University, Second Medical College of Wenzhou Medical University, Zhejiang Spine Center, Wenzhou, Zhejiang, China.
Yong-Long
YL
Chi
Laboratory of Internal Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Li-Hui
LH
Yin
Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical University, Second Medical College of Wenzhou Medical University, Zhejiang Spine Center, Wenzhou, Zhejiang, China.
Wen-Fei
0000-0001-8823-6402
WF
Ni
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000601:surgery; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods; D013168:Spondylolisthesis / Q000601:surgery*; D016896:Treatment Outcome; D064232:Visual Analog Scale