Minimally Invasive Surgery Versus Open Surgery Spinal Fusion for Spondylolisthesis: A Systematic Review and Meta-analysis

STUDY DESIGN.Systematic review and meta-analysis OBJECTIVE.Compare minimally invasive surgery (MIS) and open surgery (OS) spinal fusion outcomes for the treatment of spondylolisthesis. SUMMARY OF BACKGROUND DATA.OS spinal fusion is an interventional option for patients with spinal disease who have failed conservative therapy. Over the past decade, MIS approaches have increasingly been used, with potential benefits of reduced surgical trauma, postoperative pain and length of stay. However, current literature consists of single center, low-quality studies with no review of approaches specific to spondylolisthesis only. METHODS.This first systematic review of the literature regarding MIS and OS spinal fusion for spondylolisthesis treatment was performed using the PRISMA guidelines for article identification, screening, eligibility and inclusion. Electronic literature search of Medline/Pubmed, Cochrane, EMBASE and Scopus databases yielded 2489 articles. These articles were screened against established criteria for inclusion into this study. RESULTS.A total of 5 retrospective and 5 prospective articles with a total of 602 patients were found. Reported spondylolisthesis grades were I and II only. Overall, MIS was associated with less intraoperative blood loss (Mean Difference (MD), -331.04 mL; 95% CI, -490.48 to -171.59, p