The clinical value of oblique lateral interbody fusion in lumbar degenerative diseases: a meta-analysis

Q4 Medicine

中华骨科杂志 Pub Date : 2019-11-01 DOI:10.3760/CMA.J.ISSN.0253-2352.2019.21.004

Chong Tang, Zheng Liu, Sijun Wu, Zhenpeng Guan, Z. Pei, Wenlong Wang

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Abstract

Objective To evaluate the safety and efficacy of oblique lateral interbody fusion (OLIF) in the surgical treatment of lumbar degenerative diseases. Methods All literatures of OLIF performed in lumbar degenerative diseases were searched in recognized databases including Pubmed, OVID, Embase, Cochrane Library, Science Direct, springer, CNKI, Wanfang and VIP databases. Methodological Indexfor Non-randomized Studies (MINORS) was used to evaluate the quality of the literatures. The meta-analysis was performed using Review Manager 5.3 and Stata 15.0 statistical software. Results A total of 35 literatures were included, including 22 English literatures and 13 Chinese literatures. There were 3 630 patients with 45.2% of males, aged from 14 to 89 years old (mean, 62.6 years). The average of length of stay (LOS), operation time (OT) and blood loss (BL) of OLIF procedure were 6.7 days, 117 minutes, and 128 ml, respectively. The VAS scores of low back pain of postoperative and final follow-up decreased by 4.33 and 4.70, respectively. The VAS scores of leg pain decreased by 4.57 points and 5.31, respectively. Compared with preoperative, the postoperative JOA score increased by 7.58 and the postoperative ODI were also improved by 33.89%. All the postoperative imaging data were significantly different from those before surgery. The surgical level intervertebral heightincreased 4.14 mm, and the intervertebral foramen height and intervertebral foramen area increased by 3.54 mm, 53.96 mm2, while the dura sac cross-sectional area increased by 36.61 mm2, and the overall lumbar lordosis increased by 13.78° with the local segmental lordosis increased by 4.62°. The overall incidence of complications of OLIF was 32%, with a 95% confidence interval of 25%-38%. Conclusion OLIF is a minimally invasive procedure for the treatment of lumbar degenerative diseases. OLIF has a simply procedure and short learning curve, with short LOS and operation time, less blood loss. OLIF can effectively open the narrow intervertebral space and increase the spinal canal and nerve root canal, significantly improve the symptoms, while the complication rate is low, so OLIF is worthy of widespread clinical application. Key words: Lumbar vertebrae; Spinal fusion; Meta-analysis

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斜外侧椎间融合术治疗腰椎退行性疾病的临床价值:一项meta分析

目的评价斜侧融合术（OLIF）治疗腰椎退行性疾病的安全性和有效性。方法检索Pubmed、OVID、Embase、Cochrane Library、Science Direct、springer、CNKI、Wanfang和VIP等公认数据库中关于OLIF治疗腰椎退行性疾病的文献。采用非随机研究方法学索引（MINORS）对文献质量进行评价。使用Review Manager 5.3和Stata 15.0统计软件进行荟萃分析。结果共收录文献35篇，其中英文文献22篇，中文文献13篇。患者3630例，男性45.2%，年龄14～89岁（平均62.6岁）。OLIF手术的平均住院时间（LOS）、手术时间（OT）和失血量（BL）分别为6.7天、117分钟和128毫升。术后和最终随访的腰痛VAS评分分别下降了4.33和4.70。腿部疼痛VAS评分分别下降4.57分和5.31分。与术前相比，术后JOA评分提高了7.58分，术后ODI也提高了33.89%。所有术后影像学数据均与术前有显著差异。手术水平椎间高度增加4.14mm，椎间孔高度和椎间孔面积增加3.54mm，53.96mm2，硬膜囊横截面积增加36.61mm2，整体腰椎前凸增加13.78°，局部节段性前凸增加4.62°。OLIF并发症的总发生率为32%，95%置信区间为25%-38%。结论OLIF是一种微创治疗腰椎退行性疾病的方法。OLIF程序简单，学习曲线短，LOS和手术时间短，出血量少。OLIF能有效打开狭窄的椎间隙，增加椎管和神经根管，显著改善症状，同时并发症发生率低，值得临床广泛应用。关键词：腰椎；脊柱融合术；Meta分析

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