Minimally Invasive Lumbar Spinal Fusion Is More Effective Than Open Fusion: A Meta-Analysis

Yonsei Medical Journal
Yung ParkJoong Won Ha

Abstract

To evaluate the efficacy of minimally invasive spinal fusion in comparison to open fusion for adult lumbar spondylolisthesis or spondylosis. The present study was conducted as a meta-analysis of all estimates from studies that were selected after comprehensive literature search by two independent reviewers. Of 745 articles, nine prospective cohort studies were identifed. The quality of evidence was downgraded because of study design, inconsistency, imprecision, and publication bias. Greater Oswestry Disability Index score improvement [weighted mean difference (WMD), 3.2; 95% confdence interval (CI), 1.5 to 5.0; p=0.0003] and a lower infection rate (odds ratio, 0.3; 95% CI, 0.1 to 0.9; p=0.02) were observed in the minimally invasive group (low-quality evidence). The minimally invasive group had less blood loss (WMD, 269.5 mL; 95% CI, 246.2 to 292.9 mL; p<0.0001), a shorter hospital stay (WMD, 1.3 days; 95% CI, 1.1 to 1.5 days, p<0.0001), and longer operation time (WMD, 21.0 minutes; 95% CI, 15.9 to 26.2 minutes; p<0.0001) and radiation exposure time(WMD, 25.4 seconds; 95% CI, 22.0 to 28.8 seconds, p<0.0001) than the open group (low-quality evidence). There were no significant differences in pain improvement, fusion rate, complic...Continue Reading

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Citations

Dec 7, 2019·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Sudhir DiwanKevin Liang
May 20, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Haruo KannoEiji Itoi
Jun 25, 2021·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Tatsuya YamamotoKota Watanabe

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