Abstract
BACKGROUND: There is no conclusive evidence from evidence-based medicine that clarifies whether the efficacy and safety of lateral lumbar interbody fusion (LLIF) differ significantly with or without auxiliary posterior fixation. This study embarks on a comprehensive comparative meta-analysis, delving into both domestic and international research landscapes, to scrutinize the efficacy of stand-alone LLIF versus LLIF coupled with auxiliary posterior fixation in the treatment of degenerative lumbar diseases. METHODS: In this meta-analysis, we searched Pubmed, Embase, and Cochrane databases from inception to December 2023. This study includes research comparing LLIF combined with auxiliary posterior fixation versus stand-alone LLIF in the treatment of lumbar degenerative disease. and we excluded studies without full-text or for which data extraction was not possible; studies using animal studies; reviews and systematic reviews. Review manager 5.3 software was used to analyze the data. RESULTS: Twelve literatures are included in this study, all of which are cohort studies. The sample sizes varied between 30 and 132, totaling 781 patients, of which 440 belonged to the group with posterior fixation, and 224 to the stand-alone group. Findings revealed a significantly higher fusion rate when LLIF was combined with auxiliary posterior fixation compared to stand-alone LLIF. Additionally, postoperative disc height and restoration in segmental lordosis of LLIF combined with auxiliary posterior fixation were all significantly higher than that of stand-alone LLIF. However, postoperative VAS score for LLIF combined with auxiliary posterior fixation is significantly higher than that for stand-alone LLIF. There were no significant differences in the restoration of lumbar lordosis, the ODI and incidence of adverse events. CONCLUSIONS: In summary, compared to standalone LLIF, the combination of LLIF with auxiliary posterior fixation exhibits a higher postoperative fusion rate. Additionally, both postoperative disc height and restoration of segmental lordosis are significantly greater. Although the occurrence of adverse reactions is consistent between the two surgical approaches, the LLIF combined with auxiliary posterior fixation approach demonstrates a lower reoperation rate.