From: Open versus minimally invasive TLIF: literature review and meta-analysis
Author | Zhang et al. [14] | Yang et al. [15] | Tschugg et al. [16] | Kulkarni et al. [17] | Hey et al. [18] | Adogwa et al. [19] |
Year of publication | 2017 | 2017 | 2017 | 2016 | 2015 | 2015 |
Study design | Retrospective | RCT | Retrospective | Prospective | Prospective | Prospective |
Level of evidence | – | II | – | – | – | – |
Number of patients | 107 (M = 48, O = 59) | 41 (MI = 21, O = 20) | 67 (MI = 19, O = 48) | 61 (MI = 36, O = 25) | 50 (MI = 25, O = 25) | 148 (MI = 40, O = 108) |
Follow-up (months) | – | Minimum 24 months | 3 months | 36.5 months (mean follow-up) | Minimum 24 months | 24 months |
Mean patient age (years) | MI: 55.7, O: 59.7 | MI: 63.5, O: 58.0 | MI: 63.9, O: 64.4 | MI: 51.55, O: 50.4 | MI: 43.6, O: 44.4 | MI: 56.62, O: 56.12 |
Gender (m/f) | MI: 24/24, O: 32/27 | MI: 7/14, O: 8/12 | MI: 8/11, O: 16/32 | MI: 10/26, O: 11/14 | MI: 13/12, O: 13/12 | MI: 20/20, O: 47/61 |
Diagnosis | -DDD (MI/O: 40/47) -Spinal instability (MI/O: 8/12) | -Spinal stenosis (MI/O: 11/9) -Olisthesis (MI/O: 5/6) -Disc herniation with segmental instability (MI/O: 5/5) | -Lumbar spondylodiscitis | -Olisthesis (MI/O: 30/12) -Disc herniation (MI/O: 5/11) -Lumbar canal stenosis (MI/O: 1/2) | -DDD: (MI/O: 2/2) -Prolapsed intervertebral discs (MI/O: 12/12) -Spinal stenosis (MI/O: 3/3) -Spondylolisthesis (MI/O: 7/7) | -DDD: (MI/O: 27/81) -Olisthesis (MI/O: 29/78) |
Outcomes | Operative time (min), LOS (days), HBL, TBL, PBL | VAS (back, leg), ODI, operative time (min), interbody fusion (grade I—Bridwell criteria), HBL, TBL | Intraoperative blood transfusion, operative time, LOS, postoperative complications | VAS (back, leg), ODI, LOS, operative time, radiation exposure, QCRP, blood loss | Operation time, EBL, drop in hemoglobin on the first postoperative day, LOS, duration to ambulation, ODI, cage height and fusion rates, complications | VAS (back, leg), ODI, complications |
Author | Yee et al. [20] | Terman et al. [21] | Wong et al. [22] | Sulaiman et al. [13] | Singh et al. [23] | Gu et al. [24] |
Year of publication | 2014 | 2014 | 2014 | 2014 | 2014 | 2014 |
Study design | Retrospective | Retrospective | Prospective | Retrospective | Prospective | Prospective |
Level of evidence | – | – | – | – | – | – |
Number of patients | 68 (MI = 52, O = 16) | 74 (MI = 53, O = 21) | 198 (MI = 144, O = 54) | 68 (MI = 57, O = 11) | 66 (MI = 33, O = 33) | 82 (MI = 44, O = 38) |
Follow-up (months) | Minimum 6 months | 30 months (mean follow-up) | 45 months (mean follow-up) | – | – | 20 months (mean follow-up) |
Mean age (years)I | MI: 47.9, O: 56.1 | MI: 52.4, O: 58.2 | MI: 61, O: 58 | MI: 61.1, O: 56.4 | MI: 51.67, O: 49.85 | MI: 66.4, O: 64.1 |
Gender (m/f) | MI: 24/28, O: 5/11 | MI: 24/29, 0: 13/8 | MI: 61/83, O: 25/29 | MI: 17/40, O: 4/7 | MI: 23/10, O: 21/12 | MI: 19/25, O: 15/23 |
Diagnosis | -DDD (MI/O: 17/2) -Herniated disc (7/0) -Olisthesis (MI/O: 24/12) -Stenosis (MI/O: 4/2) | -DDD or spondylosis (MI/O: 10/5) -Herniated disc (MI/O: 3/0) -Olisthesis (MI/O: 32/14) -Stenosis (MI/O: 8/2) | -Olisthesis +/− tilt with stenosis -Post-laminectomy instability with stenosis -DDD | Grade 1–2 degenerative olisthesis | -DDD (MI/O: 19/19) -Olisthesis (MI/O: 6/9) -Spinal stenosis (MI/O: 8/5) | -DDD (MI/O: 15/11) -Two-level lumbar stenosis (MI/O: 18/14) -Lumbar stenosis with segmental instability (MI/O: 11/13) |
Outcomes | Development of symptomatic ASD (defined by: 1. new back and/or leg pain, 2. imaging findings adjacent to original surgical level, 3. decision to treat) | VAS, ODI, EBL, LOS; in obese patients | Blood loss, operative time, VAS, ODI, LOS, inpatient institutional costs, radiation exposure, fusion rates, segmental lordosis correction, complications and revisions | Operation time, EBL, perioperative complications, LOS, VAS, ODI, hospital costs | Operation time, LOS, EBL, anesthesia time (minutes), VAS, hospital costs/ payment amount | Operation time, intraoperative blood loss, transfusion volume, LOS, radiation exposure time, VAS, ODI, fusion rates, complications |
Author | Brodano et al. [25] | Seng et al. [26] | Cheng et al. [27] | Lau et al. [28] | Rodriguez-Vela et al. [29] | Parker et al. [30] |
Year of publication | 2013 | 2013 | 2013 | 2013 | 2013 | 2013 |
Study design | Retrospective | Retrospective | Retrospective | Retrospective | Prospective | Prospective |
Level of evidence | – | III | – | – | – | – |
Number of patients | 64 (MI = 30, O = 34) | 80 (MI = 40, O = 40) | 75 (MI = 50, O = 25) | 127 (MI = 78, O = 49) | 41 (MI = 21, O = 20) | 100 (MI = 50, O = 50) |
Follow-up (months) | 23 months (mean follow-up) | 60 months | 60 months (average follow-up) | – | Minimum 36 months | 24 months |
Mean age (years) | MI: 46, O: 51 | MI: 56.6, O: 56.8 | MI: 53.7, O:54.3 | -Class I obesity (BMI 30.0–34.9 kg/m2): MI: 52.5, O:54.1 -Class II obesity (BMI 35.0–39.9 kg/m2): MI: 50.5, O: 57.4 -Class III obesity (BMI > 40): MI: 53.5, O: 59.4 | MI: 41.81, O: 43.15 | MI: 53.5, O: 52.6 |
Gender (m/f) | MI: 18/12, O: 20/14 | MI: 7/33, O: 7/33 | MI: 27/23, O: 14/11 | MI: 38/40, O: 23/26 | MI: 14/7, O: 13/7 | MI: 16/34, O: 18/32 |
Diagnosis | -DDD -Grade I degenerative olisthesis | -Olisthesis (MI/O: 31/33) -DDD with spinal stenosis (MI/O: 9/7) | -Spondylosis (MI/O: 28/12) -Olisthesis (MI/O: 27/14) -> Grades I and II (MI/O: 27/12) -> Grades III and IV (MI/O: 0/2) -Foraminal stenosis (MI/O: 25/10) | -Olisthesis (MI/O: 50/25) -DDD alone (MI/O: 12/12) -DDD with stenosis (MI/O: 9/11) -DDD with deformity (MI/O: 1/0) -DDD with disc herniation (MI/O: 6/1) | -DDD | -Grade I degenerative olisthesis |
Outcomes | VAS, ODI, TBL, LOS, operation time, complications | VAS, ODI, radiation exposure time, operative time, LOS, complication rate, fusion rates (Bridwell criteria) | Postoperative pain medication, functional ability, VAS, EBL, operative time, LOS, fusion rates, complications, inpatient hospitalization costs | EBL, complications (total, intraoperative and 30-day postoperative), LOS | VAS, NASS, ODI, SF-36 Health Survey, postoperative complications | VAS, ODI, SF-36 Health Survey, operative time, EBL, complications, LOS, narcotic independence, return to work, hospital costs (direct and indirect) |
Author | Adogwa et al. [31] | Wang et al. [32] | Pelton et al. [33] | Lee et al. [6] | Parker et al. [34] | Lau et al. [35] |
Year of publication | 2012 | 2012 | 2012 | 2012 | 2012 | 2010 |
Study design | Prospective | Prospective | Prospective | Prospective | Prospective | Retrospective |
Level of evidence | – | – | – | – | – | – |
Number of patients | 21 (MI = 14, O = 7) | 81 (MI = 42, O = 39) | 66 (MI = 33, O = 33) | 144 (MI = 72, O = 72) | 30 (MI = 15, O = 15) | 22 (MI = 10, O = 12) |
Follow-up (months) | 24 months | 36 months (mean follow-up) | – | 24 months | 24 months | Minimum 12 months |
Mean age (years) | MI: 48.14, O: 47.28 | MI: 56.4, O: 54.2 | MI:51.67, O: 49.85 | MI: 52.2, O: 56.6 | MI: 50.8, O: 49.7 | MI: 46.9, O: 56.9 |
Gender (m/f) | MI: 4/10, O: 3/4 | MI: 13/29, O: 12/27 | MI: 23/10, O: 21/12 | MI: 20/52, O: 22/50 | MI: 7/8, O: 5/10 | MI: 4/6, O: 5/7 |
Diagnosis | -DDD -Grade I olisthesis | -Stenosis (MI/O: 23/20) -Olisthesis (MI/O: 14/15) -Postoperative instability (MI/O: 5/4) | -DDD (MI/O: 13/14) -Olisthesis (MI/O: 20/19) | -Olisthesis (grades I and II) -Recurrent prolapsed disc -Spinal stenosis -DDD | -Grade I degenerative olisthesis | -Spondylosis (MI/O: 5/6) -Olisthesis (MI/O: 4/6) -Spondylolysis (MI/O: 1/0) |
Outcomes | VAS, ODI, SF-36 Health Survey, operative time, EBL, LOS, duration of narcotic use, time to return to work, CPK (preoperative; days 1and 7, and 1.5, 3, and 6 months postoperative) | Operative time, blood loss, X-ray exposure time, complications, fusion rates, VAS, ODI—in overweight and obese patients | Operative time, EBL, LOS, anesthesia time, VAS, direct and indirect costs—in WC and non-WC patients | VAS, ODI, SF-36 Health Survey, NASS, time to return to full function, operative time, EBL, radiation exposure time, complications, fusion rates (Bridwell grading system) | VAS, ODI, quality of life (EuroQuol-5D), duration of narcotic use, time to return to work, direct and indirect costs, operative time, EBL, complications, LOS, fusion rates | Operative time, blood loss, LOS, pain scores, blood transfusion, time to ambulation, complications |
Author | Adogwa et al. [36] | Wang et al. [37] | Villavicencio et al. [14] | Shunwu et al. [38] | Wang et al. [37] | Peng et al. [39] |
Year of publication | 2010 | 2010 | 2010 | 2009 | 2010 | 2009 |
Study design | Retrospective | Prospective | Retrospective | Prospective | Prospective | Prospective |
Level of evidence | – | – | – | – | – | – |
Number of patients | 30 (MI = 15, O = 15) | 52 (MI = 25, O = 27) | 139 (MI = 76, O = 63) | 62 (MI = 32, O = 30) | 85 (MI = 42, O = 43) | 58 (MI = 29, O = 29) |
Follow-up (months) | 24Â months | 27.5 (mean follow-up) | 37.5 (average follow-up) | 24Â months (minimum follow-up) | 26.3 (mean follow-up) | 24Â months (minimum follow-up) |
Mean age (years) | MI: 50.8, O: 49.7 | MI: 54.8, O: 56.2 | MI: 50.5, O: 58.9 | MI: 51.4, O: 52.0 | MI: 47.9, O: 53.2 | MI: 54.1, O: 52.5 |
Gender (m/f) | MI: 7/8, O: 5/10 | MI: 13/12, O: 15/12 | MI: 45/31, O: 38/25 | MI: 18/14, O: 14/16 | MI: 13/29, O: 16/27 | MI: 5/24, O: 5/24 |
Diagnosis | Grade I Olisthesis | -Recurrent disc herniation (MI/O: 7/8) -Lumbar canal stenosis(MI/O: 10/9) -Segmental instability (MI/O: 5/7) -Olisthesis < Grade II (MI/O: 3/3) | -DDD with/without disc herniation -Olisthesis -Stenosis at one or two spinal levels | -Discogenic low back pain (MI/O: 6/4) -Unilateral lumbar disc herniation (MI/O: 13/4) -Foraminal stenosis (MI/O: 3/8) -Separation of posterior ring apophysis (MI/O: 3/4) -Low-grade olisthesis (MI/O: 5/8) -Single-segment instability (MI/O: 2/2) | -Degenerative Olisthesis (MI/O: 24/22) -Isthmic Olisthesis (MI/O: 18/21) | -Grade I/II Olisthesis -DDD presenting with low back pain and radicular symptoms |
Outcomes | VAS, ODI, EuroQol-5D, occupational disability, narcotic use, time to return to work, operative time, EBL | VAS, ODI, operative time, blood loss, radiation exposure time, complications, fusion rates | Operative time, EBL, LOS, VAS, patient satisfaction, MacNab’s criteria fusion rates, complications (major, minor) | Operative time, blood loss, total transfusion volume, LOS, time to ambulation, complications, serum CK, VAS, ODI, fusion rates | Operative time, transfusion volume, X-ray exposure times, LOS, complications, VAS, ODI, fusion rates | NASS, ODI, VAS, SF-36, operative time, blood loss, radiation exposure time, time to ambulation, narcotic use, fusion rates (Bridwell criteria) |
Author | Dhall et al. [40] | Schizas et al. [41] | Â | Â | Â | Â |
Year of publication | 2008 | 2008 | Â | Â | Â | Â |
Study design | Retrospective | Prospective | Â | Â | Â | Â |
Level of evidence | – | – |  |  |  |  |
Number of patients | 42 (MI = 21, O = 21) | 36 (MI = 18, O = 18) |  |  |  |  |
Follow-up (months) | 24Â months (MI), 34Â months (O) (mean follow-up) | 22Â months (MI), 24Â months (O) (average follow-up) | Â | Â | Â | Â |
Mean age (years) | MI: 53, O: 53 | MI: 45.5, O: 48.1 | Â | Â | Â | Â |
Gender (m/f) | – | – |  |  |  |  |
Diagnosis | -DDD (MI/O: 14/10) -Degenerative olisthesis (MI/O: 7/11) | -Isthmic Olisthesis (MI/O: 15/6) -Asymmetrical disc disease with foraminal stenosis (MI/O: 2/12) -Iatrogenic spondylosis (MI/O: 1/0) | Â | Â | Â | Â |
Outcomes | Operative time, EBL, LOS, complications, fusion rates, mPS | Operative time, intraoperative and total blood loss, radiation exposure time, VAS and ODI scores, analgesia intake, fusion rates, complications, learning curve | Â | Â | Â | Â |