Introduction
Material and methods
Data sources and searches
Inclusion and exclusion criteria
The inclusion criteria were listed as follows
The following exclusion criteria were used
Data extraction
Outcome measures
Data quality assessment
Data synthesis and analysis
Results
Literature search results and literature screening flow
No. | Author (year) | Country | Study type | Sex (male/female) | Age | Operation level | Follow-up/month | Outcome measures | |||
---|---|---|---|---|---|---|---|---|---|---|---|
Endo-TLIF | MIS-TLIF | Endo-TLIF | MIS-TLIF | Endo-TLIF | MIS-TLIF | ||||||
1 | Lim, 2017 [25] | Korea | CC | 13/10 | 22/14 | 62.7 ± 4.1 | 58.2 ± 8.2 | L2-3: 1 L3-4: 2 L4-5: 12 L5-S1: 7 | L2-3: 2 L3-4: 4 L4-5: 20 L5-S1: 10 | ≥ 12 | ①③④⑥ |
2 | AO, 2020 [4] | China | PCS | 16/19 | 22/18 | 52.80 ± 7.50 | 53.68 ± 7.24 | L3-4: 1 L4-5: 25 L5-S1: 9 | L3-4: 1 L4-5: 19 L5-S1: 2 | ≥ 12 | ①②③④⑤⑥⑦⑧ |
3 | Gatam, 2020 [26] | Indonesia | CC | 26/46 | 28/45 | 55.1 ± 5.12 | 52.3 ± 6.13 | L3-4: 8 L4-5: 56 L5-S1: 8 | L3-4: 10 L4-5: 48 L5-S1: 5 | ≥ 12 | ④ |
4 | Kim, 2020 [19] | Korea | PCS | 17/15 | 25/30 | 70.5 ± 8.26 | 67.3 ± 10.7 | L2-3: 1 L3-4: 3 L4-5: 20 L5-S1: 8 | L2-3: 0 L3-4: 2 L4-5: 46 L5-S1: 7 | 18.4 (14–38) | ①②③④⑤⑥⑧ |
5 | Zhao, 2021 [12] | China | PCS | 23/17 | 20/18 | 56.93 ± 1.66 | 57.01 ± 0.95 | L3-4: 7 L4-5: 24 L5-S1: 9 | L3-4: 8 L4-5: 22 L5-S1: 8 | 30.7 (24–34) | ④⑤⑥⑦⑧ |
6 | Lv, 2021 [22] | China | RCT | 30/24 | 26/22 | 54.96 ± 13.16 | 53.98 ± 11.51 | L3-4: 9 L4-5: 31 L5-S1: 14 | L3-4: 8 L4-5: 24 L5-S1: 16 | ≥ 18 | ①②③④⑤⑥⑦⑧ |
7 | Kang, 2021 [23] | Korea | PCS | 17/30 | 17/15 | 66.87 ± 10.41 | 66.38 ± 9.45 | L2-3: 4 L3-4: 7 L4-5: 34 L5-S1: 20 | L2-3: 1 L3-4: 9 L4-5: 22 L5-S1: 11 | 15.01 ± 2.53 | ④⑥⑦⑧ |
8 | Zhang, 2021 [14] | China | CC | 12/20 | 14/16 | 53.1 ± 12.8 | 55.7 ± 14.2 | L3-4: 3 L4-5: 28 L5-S1: 1 | L3-4: 1 L4-5: 27 L5-S1: 2 | ≥ 12 | ①②③④⑤⑥⑦ |
9 | Chang, 2022 [24] | China | PCS | 26 | 32 | 57.2 ± 13.5 | 56.1 ± 12.1 | L4-5: 26 | L4-5: 32 | ≥ 18 | ①②③④⑥⑦ |
10 | Xue, 2022 [21] | China | CC | 20 | 20 | 46.3 ± 17.2 | 48.4 ± 13.6 | L3-4: 6 L4-5: 14 | L3-4: 5 L4-5: 15 | ≥ 18 | ①②③④⑤⑥⑦⑧ |
11 | Shi, 2023 [20] | China | CC | 32 | 32 | 59.3 ± 6.2 | 59.2 ± 5.5 | L4-5: 32 | L4-5: 32 | ≥ 18 | ①②③④⑥⑦ |
12 | Ge, 2022 [18] | China | CC | 21/20 | 19/24 | 59.6 ± 7.6 | 62.7 ± 10.4 | L3-4: 1 L4-5: 33 L5-S1: 7 | L3-4: 2 L4-5: 35 L5-S1: 6 | ≥ 18 | ①②③④⑤⑥⑦ |
13 | Han, 2022 [27] | China | CC | 18/21 | 23/20 | 60.35 ± 8.04 | 60.98 ± 6.62 | L3-4: 9 L4-5: 27 L5-S1: 3 | L3-4: 10 L4-5: 24 L5-S1: 9 | ≥ 18 | ①②③④⑤⑥⑦⑧ |
Quality evaluation results of included studies
Author (year) | Selection | Comparability | Exposure | Total score | Quality rating |
---|---|---|---|---|---|
Lim, 2020 [25] | 3 | 2 | 3 | 8 | High quality |
AO, 2020 [4] | 3 | 2 | 3 | 8 | High quality |
Gatam, 2020 [24] | 3 | 2 | 2 | 7 | High quality |
Kim, 2020 [19] | 3 | 2 | 3 | 8 | High quality |
Zhao, 2021 [12] | 3 | 2 | 2 | 7 | High quality |
Kang, 2021 [23] | 3 | 2 | 2 | 7 | High quality |
Zhang, 2021 [14] | 3 | 2 | 3 | 8 | High quality |
Chang, 2022 [24] | 3 | 2 | 2 | 7 | High quality |
Xue, 2022 [21] | 3 | 2 | 3 | 8 | High quality |
Shi, 2023 [20] | 3 | 2 | 2 | 8 | High quality |
Ge, 2022 [18] | 3 | 3 | 2 | 8 | High quality |
Han, 2022 [27] | 3 | 2 | 2 | 7 | High quality |
Outcomes of the meta-analysis
Differences in lumbar and dorsal VAS scores among groups
Differences in lower extremity pain VAS scores among groups
Results and subgroup analysis | Number of studies | Exclusion study | Heterogeneity | P (overall effect test) | ||
---|---|---|---|---|---|---|
x2 | I2, % | P | ||||
1.1 Lumbar VAS score | ||||||
1.1.1Postoperative ≤ 2 weeks | 7 | Lim, 2022 | 5.43 | 8% | 0.37 | < 0.00001 |
1.1.2 Post 3 months | 5 | Han, 2022 | 5.05 | 41% | 0.17 | < 0.00001 |
1.1.3 Final FU | 10 | Chang, 2022 | 0.98 | 0% | 1.00 | = 0.04 |
1.2 Preoperative (lower extremity pain VAS score) | 7 | Ge, 2022 | 0.02 | 27% | 0.23 | = 0.58 |
1.3 ODI score | ||||||
1.3.1 Post 3 months | 5 | Zhang, 2021 | 3.44 | 13% | 0.33 | = 0.17 |
1.3.1 Post 6 months | 3 | Zhang, 2021 | 0.00 | 0% | 0.96 | = 0.17 |
Differences in the ODI index of each group
Differences in complication rates among all groups
Study title | Endo-TLIF | MIS-TLIF | ||
---|---|---|---|---|
Complication | Sample size | Complication | Sample size | |
Lim, 2017 [25] | 2 | 23 | 2 | 36 |
AO, 2020 [4] | 1 | 35 | 1 | 40 |
Gatam, 2020 [26] | 3 | 72 | 6 | 73 |
Kim, 2020 [19] | 3 | 32 | 4 | 55 |
Zhao, 2021 [12] | 2 | 40 | 0 | 38 |
Lv, 2021 [22] | 1 | 54 | 1 | 48 |
Kang, 2021 [23] | 6 | 47 | 5 | 32 |
Zhang, 2021 [14] | 2 | 32 | 0 | 30 |
Chang, 2022 [24] | 0 | 26 | 0 | 32 |
Xue, 2022 [21] | 2 | 20 | 4 | 20 |
Shi, 2023 [20] | 7 | 32 | 2 | 32 |
Ge, 2022 [18] | 1 | 40 | 2 | 41 |
Han, 2022 [27] | 5 | 39 | 2 | 43 |
Sum | 35 | 492 | 29 | 520 |