【摘要】 目的 通过Meta分析评价微创经椎间孔腰椎椎间融合术(minimally invasive surgery transforaminal lumbar interbody fusion,MIS-TLIF)与后路腰椎椎间融合术(posterior lumbar interbody fusion,PLIF)治疗单节段腰椎滑脱症的有效性与安全性。方法 检索PubMed、Embase、Web of Science、万方数据库、中国期刊全文数据库自建库至2021年11月有关MIS-TLIF与PLIF治疗单节段腰椎滑脱症中有效性及安全性的临床对照研究，筛选符合纳入标准的文献，使用数据提取表收集相关数据，采用Revman 5.4软件行Meta分析。结果 本次Meta分析共纳入11项研究，涉及890例，其中MIS-TLIF组420例，PLIF组470例。Meta分析示，MIS-TLIF组与PLIF组在治疗单节段腰椎滑脱症术后总体并发症、椎间融合情况、手术时长方面差异均无统计学意义(P> 0.05)；与PLIF组相比，MIS-TLIF组在术中出血量(MD=-126.19,95%CI:-161.67～-90.72,P <0.01)、疼痛视觉模拟评分(visual analogue scale,VAS)(MD=-0.37,95%CI:-0.44～-0.29,P <0.01)、Oswestry功能障碍指数(oswestry disability index,ODI)(MD=-0.73,95%CI:-1.05～-0.42,P <0.01)及住院时长(MD=-3.03,95%CI:-3.31～-2.74,P <0.01)方面明显优于PLIF组，差异均有统计学意义。结论 与PLIF相比，MIS-TLIF治疗单节段腰椎滑脱症可显著降低患者术中出血量、住院时长、术后VAS评分及ODI，但两种术式在改善术后总体并发症、椎间融合情况及缩短手术时长方面无明显差异。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of minimally invasive surgery transforaminal lumbar interbody fusion( MIS-TLIF) and posterior lumbar interbody fusion( PLIF) in single-level lumbar spondylolisthesis.Methods An extensive literature search was conducted in the databases of PubMed, Embase, Web of Science, Wanfang and CNKI. Studies comparing the efficacy and safety of MIS-TLIF and PLIF in the treatment of single-level lumbar spondylolisthesis were collected. The retrieval period is from the beginning of database building to November 2021.The data were analyzed by Revman 5.4 software. Results A total of 11 studies involving 890 patients were included in this Meta-analysis, of which 420 were in the MIS-TLIF group and 470 were in the PLIF group. Meta-analysis showed that there were no significant differences between the MIS-TLIF group and PLIF group in postoperative complication,intervertebral fusion, and operation time( P > 0.05); However, the intraoperative bleeding volume( MD =-126.19,95% CI:-161.67--90.72, P < 0.01), VAS score( MD =-0.37, 95% CI:-0.44--0.29, P < 0.01), ODI( MD =-0.73,95% CI:-1.05--0.42, P < 0.01) and length of hospital stay( MD =-3.03, 95% CI:-3.31--2.74, P < 0.01) of the MIS-TLIF group were significantly better than those of the PLIF group. Conclusions Compared with the PLIF, the MIS-TLIF can significantly reduce the intraoperative blood loss, length of hospital stay, postoperative VAS and ODI in the treatment of single-level lumbar spondylolisthesis. However, there are no significant differences in postoperative complication, intervertebral fusion and operation time between the two surgical methods.更多还原