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A comparison of posterior lumbar interbody fusion and transforaminal lumbar interbody fusion: a literature review and meta-analysis.

Zhang Q, Yuan Z, Zhou M, Liu H, Xu Y, Ren Y - BMC Musculoskelet Disord (2014)

Bottom Line: We found that PLIF had a higher complication rate (P <0.00001), and TLIF reduced the rate of durotomy (P = 0.01).The evidence indicated that TLIF could reduce the complication rate and durotomy.PLIF might result in longer time in surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China. renyongxin@aliyun.com.

ABSTRACT

Background: We compared the perioperative results and complications associated with PLIF and TLIF, and collected evidence for choosing the better fusion method.

Methods: A literature survey of the MEDLINE and EMBASE databases identified 7 comparative observational studies that met our inclusion criteria. Checklists by Cowley were used to evaluate the risk of bias of the included studies. A database including patient demographic information, perioperative results, and complications was established. The summary odds ratio and weighed mean difference with 95% confidence interval were calculated with a random-effects model.

Results: We found that PLIF had a higher complication rate (P <0.00001), and TLIF reduced the rate of durotomy (P = 0.01). No statistical difference was found between the two groups with regard to clinical satisfaction (P = 0.54), blood loss (P = 0.14), vertebral root injury (P = 0.08), graft malposition (P = 0.06), infection (P = 0.36), or rate of radiographic fusion (P = 0.27). The evidence indicated that PLIF required longer operative time (P = 0.03).

Conclusions: The evidence indicated that TLIF could reduce the complication rate and durotomy. Neither TLIP nor PLIF was found superior in terms of clinical satisfaction or radiographic fusion rate. PLIF might result in longer time in surgery.

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Forest plot illustrating radiographic fusion (a) and satisfaction (b) of PLIF and TLIF.
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Fig3: Forest plot illustrating radiographic fusion (a) and satisfaction (b) of PLIF and TLIF.

Mentions: Five studies reported evaluations of satisfaction made by patients, or clinical satisfaction was assessed based on the Oswestry disability index (ODI) or Japanese Orthopedic Association (JOA) scores. No statistical difference was found between the two groups (OR 0.81, 95% CI: 0.42 to 1.57, P = 0.54). There was no evidence for significant heterogeneity (I2 = 0%, P = 0.99; Figure 3). The evidence from one-year follow-up studies showed that there was no statistically significant difference between the two procedures (OR 0.82, 95% CI: 0.28 to 2.40, P = 0.72) [21, 22, 26]. The follow-up period of two studies was two years [25, 27], and no statistical difference was found (OR 0.81, 95% CI: 0.35 to 1.86, P = 0.61). Subgroup analysis showed similar trends in the one-year and two-year follow-up periods.Figure 3


A comparison of posterior lumbar interbody fusion and transforaminal lumbar interbody fusion: a literature review and meta-analysis.

Zhang Q, Yuan Z, Zhou M, Liu H, Xu Y, Ren Y - BMC Musculoskelet Disord (2014)

Forest plot illustrating radiographic fusion (a) and satisfaction (b) of PLIF and TLIF.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4232693&req=5

Fig3: Forest plot illustrating radiographic fusion (a) and satisfaction (b) of PLIF and TLIF.
Mentions: Five studies reported evaluations of satisfaction made by patients, or clinical satisfaction was assessed based on the Oswestry disability index (ODI) or Japanese Orthopedic Association (JOA) scores. No statistical difference was found between the two groups (OR 0.81, 95% CI: 0.42 to 1.57, P = 0.54). There was no evidence for significant heterogeneity (I2 = 0%, P = 0.99; Figure 3). The evidence from one-year follow-up studies showed that there was no statistically significant difference between the two procedures (OR 0.82, 95% CI: 0.28 to 2.40, P = 0.72) [21, 22, 26]. The follow-up period of two studies was two years [25, 27], and no statistical difference was found (OR 0.81, 95% CI: 0.35 to 1.86, P = 0.61). Subgroup analysis showed similar trends in the one-year and two-year follow-up periods.Figure 3

Bottom Line: We found that PLIF had a higher complication rate (P <0.00001), and TLIF reduced the rate of durotomy (P = 0.01).The evidence indicated that TLIF could reduce the complication rate and durotomy.PLIF might result in longer time in surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China. renyongxin@aliyun.com.

ABSTRACT

Background: We compared the perioperative results and complications associated with PLIF and TLIF, and collected evidence for choosing the better fusion method.

Methods: A literature survey of the MEDLINE and EMBASE databases identified 7 comparative observational studies that met our inclusion criteria. Checklists by Cowley were used to evaluate the risk of bias of the included studies. A database including patient demographic information, perioperative results, and complications was established. The summary odds ratio and weighed mean difference with 95% confidence interval were calculated with a random-effects model.

Results: We found that PLIF had a higher complication rate (P <0.00001), and TLIF reduced the rate of durotomy (P = 0.01). No statistical difference was found between the two groups with regard to clinical satisfaction (P = 0.54), blood loss (P = 0.14), vertebral root injury (P = 0.08), graft malposition (P = 0.06), infection (P = 0.36), or rate of radiographic fusion (P = 0.27). The evidence indicated that PLIF required longer operative time (P = 0.03).

Conclusions: The evidence indicated that TLIF could reduce the complication rate and durotomy. Neither TLIP nor PLIF was found superior in terms of clinical satisfaction or radiographic fusion rate. PLIF might result in longer time in surgery.

Show MeSH
Related in: MedlinePlus