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Comparison of Fusion Rate and Clinical Outcomes in Minimally Invasive and Conventional Posterior Fusion for Lumbar Degenerative Disease: A Network Meta-Analysis – Lumbar Fusion

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The article compares the fusion rate, clinical efficacy, and complications of minimally invasive fusion surgery and open fusion surgery for the treatment of lumbar degenerative disease. The study included 38 retrospective studies with 3,097 patients and analyzed five different intervention modalities. Minimally invasive fusion surgery was found to offer better scores for low back pain and Oswestry Disability Index, lower complication rates, reduced bleeding, and shorter hospital stays compared to conventional open surgery. However, minimally invasive fusion surgery did not show a significant advantage in terms of fusion rate and had a longer operative time. The results suggest that both approaches have their own advantages and limitations in treating lumbar degenerative disease

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spine hospital on Harley Street UK

Published article

S: Compared to conventional open surgery, minimally invasive fusion surgery offered better scores for low back pain and Oswestry Disability Index, lower complication rates, reduced bleeding, and shorter hospital stays. However, minimally invasive fusion surgery did not show a significant advantage in terms of fusion rate and had a longer operative time.

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World Neurosurg. 2024 Jun 11:S1878-8750(24)00989-6. doi: 10.1016/j.wneu.2024.06.031. Online ahead of print. ABSTRACT BACKGROUND: The fusion rate, clinical efficacy, and complications of minimally invasive fusion surgery and open fusion surgery in the treatment of lumbar degenerative disease are still unclear. METHODS: We conducted a literature search using PubMed, Embase, Cochrane Library, CNKI, and WANFANG databases. RESULTS:,

World Neurosurg. 2024 Jun 11:S1878-8750(24)00989-6. doi: 10.1016/j.wneu.2024.06.031. Online ahead of print.

ABSTRACT

BACKGROUND: The fusion rate, clinical efficacy, and complications of minimally invasive fusion surgery and open fusion surgery in the treatment of lumbar degenerative disease are still unclear.

METHODS: We conducted a literature search using PubMed, Embase, Cochrane Library, CNKI, and WANFANG databases.

RESULTS: This study included 38 retrospective studies involving 3,097 patients. Five intervention modalities were considered: unilateral biportal endoscopic-lumbar interbody fusion (UBE-LIF), percutaneous endoscopic-lumbar interbody fusion (PE-LIF), minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF), transforaminal lumbar interbody fusion (TLIF), and posterior lumbar interbody fusion (PLIF). Quality assessment indicated that each study met acceptable quality standards. PE-LIF demonstrated reduced low back pain (OR=0.50, CI: 0.38-0.65) and lower complication rate (OR=0.46, CI: 0.25-0.87) compared to PLIF. However, in indirect comparisons, PE-LIF showed the lowest fusion rates, with the ranking as follows: UBE-LIF (83.2%) > MIS-TLIF (59.6%) > TLIF (44.3%) > PLIF (39.8%) > PE-LIF (23.1%). With respect to low back pain relief, PE-LIF yielded the best results, with the order of relief as follows: PE-LIF (96.4%) > MIS-TLIF (64.8%) > UBE-LIF (62.6%) > TLIF (23.0%) > PLIF (3.2%). Global and local consistency tests showed satisfactory results, and heterogeneity tests indicated good stability.

S: Compared to conventional open surgery, minimally invasive fusion surgery offered better scores for low back pain and Oswestry Disability Index, lower complication rates, reduced bleeding, and shorter hospital stays. However, minimally invasive fusion surgery did not show a significant advantage in terms of fusion rate and had a longer operative time.

PMID:38871284 | DOI:10.1016/j.wneu.2024.06.031

The London Spine Unit : most specialised spine hospital on Harley Street UK

Read the original publication:

Comparison of Fusion Rate and Clinical Outcomes in Minimally Invasive and Conventional Posterior Fusion for Lumbar Degenerative Disease: A Network Meta-Analysis

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World Neurosurg. 2024 Jun 11:S1878-8750(24)00989-6. doi: 10.1016/j.wneu.2024.06.031. Online ahead of print. ABSTRACT BACKGROUND: The fusion rate, clinical efficacy, and complications of minimally invasive fusion surgery and open fusion surgery in the treatment of lumbar degenerative disease are still unclear. METHODS: We conducted a literature search using PubMed, Embase, Cochrane Library, CNKI, and WANFANG databases. RESULTS:

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