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.
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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.
微创经椎间孔腰椎椎体间融合术（MIS-TLIF）已经成为治疗腰椎退行性滑脱的一种流行和有效的选择，特别是在老年患者中。本系统综述和荟萃分析旨在评估MIS-TLIF治疗退行性脊柱滑脱患者的长期效果。方法：我们对PubMed、Web of Science、Scopus、b谷歌Scholar等数据库的研究进行了全面的回顾和分析，涵盖了2015-2024年发表的研究。我们使用随机效应模型来估计总体患病率，并进行敏感性分析和评估发表偏倚，以了解结果的可变性。所有的分析都是使用RStudio中的“meta”和“metafor”包完成的。结果：根据随机效应模型，老年MIS-TLIF患者术后12个月VAS背部评分动态的标准化平均差异为-4.30,95% CI [-10.02；1.42);术后12个月VAS腿部疼痛评分动态为-2.46,95% CI [-5.61；0.68);术后12个月ODI评分动态为-3.01,95% CI [-6.02；-0.01]。术后24个月VAS背痛评分动态为-1.77,95% CI [-2.33；-1.21);术后24个月VAS腿部疼痛评分动态为-2.29,95% CI [-3.22]；-1.37);术后24个月ODI动态评分为-1.92,95% CI [-2.57；-1.27]。结论：我们的研究提供了令人信服的证据，支持MIS-TLIF治疗老年患者腰椎滑脱的长期疗效。研究结果表明，MIS-TLIF与背部和腿部疼痛的显著减少以及术后12个月残疾评分的改善有关。然而，这些疼痛和功能障碍的改善在术后24个月下降，这可以解释为老年人群退行性变化的生理性质。系统评价注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD42024538220, PROSPERO （CRD42024538220）。
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.
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