Minimally Invasive Versus Traditional Open Transforaminal Lumbar Interbody Fusion For The Treatment Of Single-Level Spondylolisthesis Grades 1 And 2:A Meta-Analysis

Objective:Meta-analysis was used to evaluate the safety and efficacy of MIS-TLIF and TO-TLIF in the treatment of Single-Level Spondylolisthesis Grades 1 and 2,and to provide a reference for clinicians in which surgical procedures to implement.Methods:Set up Chinese and English search terms respectively: Spondylolisthesis,Minimal invasive,Transforaminal lumbar interbody fusion,Meta-analysis to search Chinese database(CNKI database,Wanfang database,Chinese biomedical database)and English database(Pubmed,Embase,Cochrane).Endnote software was used to screen duplicate literature.I excluded unqualified literature by reading the title and abstract,and I selected literature by reading the full text according to the inclusion criteria.Then a Meta-analysis of ODI score,VAS score,number of cases of vertebral fusion,complications,operation time and intraoperative bleeding loss was made for the selected literature which met the inclusion criteria.Results:Eight papers were included by final screening,including three Chinese and five English literature.A total of 591 patients were included(282 in the minimally invasive group and 309 in the traditional open group).Six common reference indicators were analyzed by Metaanalysis and the results are as follows: 1.ODI score of the last follow-up after operation: [WMD=-5.71,95% CI(-6.27,-5.14),P < 0.00001];2.VAS score of the last follow-up after operation: [WMD=-0.56,95% CI](-1.00,-0.12),P=0.01];3.lumbar fusion cases: [OR=0.66,95% CI(0.23,1.95),P=0.46];4.postoperative complications: [OR=0.55,95% CI(0.11,2.77),P=0.47];5.operative time: [WMD = 13.65,95% CI(1.82,25.48),P = 0.02];6.intraoperative bleeding volume: [WMD = 13.65,95% CI(1.82,25.28),P=0.02].Conclusion:The ODI and VAS scores of the minimally invasive group were lower at the last followup,and the difference was statistically significant.The operation time of the minimally invasive group was longer than that of the traditional open group,and the blood loss during operation was less than the traditional open group.There was significant difference between them.But there was no significant difference between the two groups in the number of vertebral fusion cases and the number of complications.