Comparison Offusion And Complications Between Oblique Lumbar Interbody Fusionand Transforaminal Lumbar Interbody Fusion:a Meta-analysis

Background: Lumbar degenerative disease is a common lumbar disease in an aging population and the most common cause of life affecting patients.Lumbar interbody fusion is an effective treatment to relieve lumbar pain in the degenerative disease,and can indirectly decompress nerve roots,restore scoliosis and correct deformities.Transforaminal lumbar interbody fusion(TLIF)is a routine posterior fusion procedure,TLIF need resect one side of the superior and inferior articular processes and through one side of the intervertebral foramen reduces the number of important anatomical structures such as nerve roots,dura and contralateral posterior longitudinal ligament injury.TLIF applies to almost degenerative lesions including disc prolapse,disc degeneration,disc herniation,lumbar spondylolisthesis.Whereas oblique lateral intervertebral fusion(OLIF)entered the intervertebral disc space through a passage between the peritoneum and the psoas major muscle.OLIF indications include all degenerative indications.OLIF is suitable for patients with sagittal and coronal deformities,especially lumbar degenerative scoliosis.But TLIF and OLIF have their own advantages and disadvantages in the treatment of lumbar degenerative diseases.At present,there is no clear report on the fusion rate and complications of the two surgical methods.For this reason,this paper carries out Meta analysis by collecting articles of the two surgical methods to provide guidance for clinicians.Objection:By Meta-analysis being conducted on literature data,Compassion of fusion and complications between oblique lumbar interbody fusion and transforaminal lumbar interbody fusion,so as to guide clinical workers to provide guidance.Method:Through Wanfang、CNKI、VIP、Cohrane Library、Web of science、Pubmed、Embase database from 1990 to October 2019,and the retrieval was made up of the combination of the subject words and the key words at freely.Chinese keywords:"斜外侧腰椎椎间融合术"、"经椎间孔椎间融合术"、"腰椎退行性疾病".Key words in English:"oblique lumbar interbody fusion"、"transforaminal lumbar interbody fusion"、"degenerative lumbar disease".Then the literatures were scored by the quality of Newcatle-Ottawa Scale.Extracted datas contains postoperative fusion rate、complications、intraoperative hemorrhage、postoperative drainage、operation time、preoperative and postoperative VAS、preoperative and postoperative ODI.Result:Six articles of this paper were finally included in the analysis.Postoperative fusion rate、postoperative complications、operation time、 intraoperative hemorrhage、 postoperative drainage、 preoperative and postoperative VAS score and ODI score before and after operation were obtained by extracting the literature.The results of Meta analysis was obtained by the Review Manager 5.3.Results were markedly statistically significant: intraoperative hemorrhage(MDs=-3.26%CI=-4.39--2.13,I2=94%,P<0.00001),postoperative drainage(MDs=-0.72,95%CI=-0.97--0.47,I2=0%,P≤0.00001),and operative time(MDs=-1.35,95%CI=-2.20--0.49,I2=93%,P=0.002);Results were not statistically significant:fusion rate(OR=1.47,95%CI=0.55-3.90,P=0.44),complications(OR=0.74,95%CI=0.48-1.14,P=0.17),VAS scores(OR=1.47,95% CI=0.55-3.90,P=0.44),ODI scores(MDs=-0.20,95%CI=-0.41-0.01,I2=0%,P=0.06).Conclusion: OLIF than TLIF operation time is shorter,intraoperative hemorrhage is less,postoperative drainage is less,OLIF is more conducive to the rapid recovery of patients.There was no significant difference in postoperative complications,postoperative fusion rate,VAS score and ODI between the two surgical procedures.