Meta-Analysis of the Clinical Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion versus Endoscopic Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY World neurosurgery Pub Date : 2025-02-18 DOI:10.1016/j.wneu.2025.123662

Xiangxuan Li , Yiming Qu , Liang Zhou , Yanjie Zhou , Bin Peng , Jizeren Duo

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Abstract

Objective

To compare the efficacy and safety of unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) and endoscopic lumbar interbody fusion (Endo-LIF) in the treatment of lumbar degenerative diseases.

Methods

A thorough literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the PICO framework (PROSPERO 2024CRD42024592073). The databases searched included PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database, with a time frame of January 2020 to June 2024. Outcome metrics included operative time, rate of progress of surgical time for beginners, intraoperative bleeding, hidden blood loss, total blood loss (TBL), postoperative drainage, hospitalization time, visual analog score for pain, Oswestry Disability Index, complications, fusion rates, and modified MacNab score excellence rates.

Results

A total of 10 papers were included, including two that were randomized controlled trials. This study involved 710 patients, 348 in the UBE-LIF group and 362 in the Endo-LIF group. The results showed that the UBE-LIF group was superior to the Endo-LIF group in terms of operative time and rate of progress of surgical time for beginners. In contrast, the Endo-LIF group was superior to the UBE-LIF group in terms of hospitalization time, hidden blood loss, and TBL. There were no statistical differences between the two procedures regarding intraoperative bleeding, postoperative drainage, visual analog score for low back pain, Oswestry Disability Index, complications, fusion rates, and modified MacNab score excellence rates.

Conclusions

Postoperative pain and safety were comparable between the two endoscopic procedures.The UBE-LIF procedure was shorter, whereas the Endo-LIF had less TBL and a shorter recovery time.

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单侧双门静脉内窥镜腰椎椎间融合术与内窥镜腰椎椎间融合术治疗腰椎退行性疾病的临床疗效和安全性的meta分析。

目的：比较单侧双门静脉内窥镜腰椎椎体间融合术（UBE-LIF）与内窥镜腰椎椎体间融合术（Endo-LIF）治疗腰椎退行性疾病的疗效和安全性。方法：根据PRISMA指南和PICO框架（PROSPERO 2024CRD42024592073）进行全面的文献检索。检索的数据库包括PubMed、Embase、Web of Science、Cochrane Library、中国知网（CNKI）和万方数据库，时间范围为2020年1月至2024年6月。结果指标包括手术时间、新手手术时间进展率、术中出血、隐性失血量（HBL）、总失血量（TBL）、术后引流、住院时间、疼痛视觉模拟评分（VAS）、Oswestry残疾指数（ODI）、并发症、融合率和改良MacNab评分优优率。结果：共纳入10篇文献，其中2篇为RCT试验。本研究涉及710例患者，其中348例为UBE-LIF组，362例为Endo-LIF组。结果显示，UBE-LIF组在手术时间和新手手术时间进展率方面均优于Endo-LIF组。相比之下，Endo-LIF组在住院时间、隐性失血量和总失血量方面均优于UBE-LIF组。两种手术在术中出血、术后引流、腰痛视觉模拟评分、Oswestry残疾指数、并发症、融合率和改良MacNab评分优优率方面无统计学差异。结论：两种内镜手术的术后疼痛和安全性相当。UBE-LIF手术时间更短，而Endo-LIF的总失血量更少，恢复时间更短。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS