Effect of Lateral Surgery Compared with Posterior Surgery on Lumbar Degenerative Disease: A Meta-Analysis of 41 Cohort Studies

Abstract

PurposeThe purpose of this study was to compare the efficacy of the lateral approach and posterior approach in the treatment of lumbar degenerative diseases. MethodsThrough a systematic search of relevant articles published on or before July 20, 2023, in the Embase, PubMed and Cochrane libraries, the two authors independently extracted data and used the Newcastle‒Ottawa scale (NOS) to evaluate the quality of the included studies. Using Stata16 software, the continuous variables were presented as the standard mean deviation (SMD), and the bipartite variables were analyzed using the pooled odds ratio (ORs) with 95% confidence interval (CIs). ResultsA total of 13,892 articles were screened, and 10,908 studies were identified after deleting duplicates, of which 41 met the criteria and were included in the meta-analysis. The meta-analysis showed that the lateral approach was superior to the posterior approach in reducing blood loss, operation time and hospital stay. At the same time, compared with the posterior approach, the lateral approach has more advantages in the long-term JOA score and ODI score, adjusting mid-term and long-term LL and short-term and long-term DH. ConclusionLateral and posterior surgery have similar clinical effects in the treatment of lumbar degenerative diseases and can significantly reduce pain and improve postoperative SL. At the same time, the lateral approach has more advantages in improving long-term quality of life, reducing the long-term disability index, adjusting mid-term and long-term LL and short-term and long-term DH.