Long term clinical outcomes of minimally invasive transforaminal interbody fusion (MIS-TLIF) for lumbar spondylolisthesis in a geriatric (>65 years) population: a systematic review and meta-analysis.
{"title":"Long term clinical outcomes of minimally invasive transforaminal interbody fusion (MIS-TLIF) for lumbar spondylolisthesis in a geriatric (>65 years) population: a systematic review and meta-analysis.","authors":"Talgat Kerimbayev, Yerzhan Kuanyshbekov, Serik Akshulakov, Indira Karibayeva","doi":"10.3389/fsurg.2025.1517947","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) technique has become a popular and effective option for treating lumbar degenerative spondylolisthesis, especially in elderly patients. This systematic review and meta-analysis is to evaluate the long-term results of MIS-TLIF for patients with degenerative spondylolisthesis.</p><p><strong>Methods: </strong>We thoroughly reviewed and analyzed studies from databases like PubMed, Web of Science, Scopus, and Google Scholar, covering research published from 2015-2024. We used random-effects models to estimate overall prevalence, and we conducted sensitivity analyses and assessed publication bias to understand the variability in results. All analyses were done using the \"meta\" and \"metafor\" packages in RStudio.</p><p><strong>Results: </strong>According to the random-effects model, the pooled standardized mean difference of the VAS back score dynamics at 12 months post-operative in geriatric MIS-TLIF patients was -4.30, 95% CI [-10.02; 1.42]; the VAS leg pain score dynamics at 12 months post-operative was -2.46, 95% CI [-5.61; 0.68]; the ODI score dynamics at 12 months post-operative was -3.01, 95% CI [-6.02; -0.01]. The VAS back pain score dynamics at 24 months post-operative was -1.77, 95% CI [-2.33; -1.21]; the VAS leg pain score dynamics at 24 months post-operative was -2.29, 95% CI [-3.22; -1.37]; and the ODI score dynamics at 24 months post-operative was -1.92, 95% CI [-2.57; -1.27].</p><p><strong>Conclusion: </strong>Our study provides compelling evidence supporting the long-term efficacy of MIS-TLIF for managing lumbar spondylolisthesis in geriatric patients. The findings suggest that MIS-TLIF is associated with significant reductions in back and leg pain, as well as improvements in disability scores over 12 months post-operatively. However, these improvements in pain and functional disability decline at 24 months postoperatively, which could be explained by the physiological nature of degenerative changes in the geriatric population.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024538220, PROSPERO (CRD42024538220).</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1517947"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968762/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1517947","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) technique has become a popular and effective option for treating lumbar degenerative spondylolisthesis, especially in elderly patients. This systematic review and meta-analysis is to evaluate the long-term results of MIS-TLIF for patients with degenerative spondylolisthesis.
Methods: We thoroughly reviewed and analyzed studies from databases like PubMed, Web of Science, Scopus, and Google Scholar, covering research published from 2015-2024. We used random-effects models to estimate overall prevalence, and we conducted sensitivity analyses and assessed publication bias to understand the variability in results. All analyses were done using the "meta" and "metafor" packages in RStudio.
Results: According to the random-effects model, the pooled standardized mean difference of the VAS back score dynamics at 12 months post-operative in geriatric MIS-TLIF patients was -4.30, 95% CI [-10.02; 1.42]; the VAS leg pain score dynamics at 12 months post-operative was -2.46, 95% CI [-5.61; 0.68]; the ODI score dynamics at 12 months post-operative was -3.01, 95% CI [-6.02; -0.01]. The VAS back pain score dynamics at 24 months post-operative was -1.77, 95% CI [-2.33; -1.21]; the VAS leg pain score dynamics at 24 months post-operative was -2.29, 95% CI [-3.22; -1.37]; and the ODI score dynamics at 24 months post-operative was -1.92, 95% CI [-2.57; -1.27].
Conclusion: Our study provides compelling evidence supporting the long-term efficacy of MIS-TLIF for managing lumbar spondylolisthesis in geriatric patients. The findings suggest that MIS-TLIF is associated with significant reductions in back and leg pain, as well as improvements in disability scores over 12 months post-operatively. However, these improvements in pain and functional disability decline at 24 months postoperatively, which could be explained by the physiological nature of degenerative changes in the geriatric population.
期刊介绍:
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.