A Meta-analysis of Posterior Lumbar Interbody Fusion Versus Posterolateral Fusion in the Short-level Lumbar Diseases Spondylolisthesis

FANG Wang; SHI Qing-peng; TANG Jian

Abstract：Objective To systematically compare and evaluate internal fixation and posterior lumbar interbody fusion (PLIF)and internal fixation and posterolateral fusion(PLF)in short-level lumbar spondylolisthesis. Methods The references from inception to September 2013 concerning PLIF and PLF for the short-level lumbar spondylolisthesis were retrieved through Medline,PubMed,Cochrane Library,Ovid,SpringerLink,the China Biological Medicine Database,Wafang Database and Weipu Database,as well as by manually searching the related journals and grey literature. The eligible trials were extracted according to the inclusion and exclusion criteria. The included trials were evaluated the methodological quality. RevMan5. 1 software was used for data analysis. Results The Five RCTs were included in the final meta-analysis,enrolling a total of 203 PLF cases and 206 PLIF cases. The results of meta-analysis showed that statistically difference between PLF and PLIF in the mean operation time(MD = - 29. 71,95% CI:- 42. 85 ~ - 16. 57,P ﹤ 0. 00001)andfusionrate(OR = 0. 41,95% CI:0. 22 ~ 0. 76,P =0. 005). There were no statistically difference in mean blood loss(MD = 172. 35,95% CI:- 78. 03 ~ 422. 729,P = 0. 18), complicationrate(OR = 1. 62,95% CI:0. 59 ~ 4. 51,P = 0. 35),reoperationrate(OR = 3. 03,95% CI:0. 46 ~ 20. 00,P =0. 25)and excellent and good rate of clinical outcomes(OR = 0. 59,95% CI:0. 30 ~ 1. 15,P = 0. 12). Conclusion The meta-analysis shows that the PLF has less mean operation time than PLIF and PLIF has higher fusion rate than PLF. However,this meta-analysis has several main limitations,so high-quality randomized controlled trials with long-term follow-up are needed to further assess these outcomes.