Comparison of Endoscopic and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Disease: A Meta-Analysis

Study Design: Systematic review and meta-analysis.Objectives: To compare the clinical outcomes of endoscopic transforaminal lumbar interbody fusion (E-TLIF) and minimally invasive TLIF (MIS-TLIF) in patients with degenerative lumbar disease (DLD).Summary of Literature Review: Both E-TLIF and MIS-TLIF have been widely used to treat DLD due to their minimally invasive nature.However, few studies have directly compared their clinical outcomes, and existing evidence remains inconclusive.Materials and Methods: A comprehensive literature search was performed in Medline, Cochrane, Scopus, and Embase for studies published between January 2000 and April 2025.We included studies that compared the clinical outcomes of E-TLIF and MIS-TLIF in patients with DLD and reported postoperative measures including visual analog scale (VAS) scores for low back pain and leg pain, Oswestry Disability Index (ODI), and complication rates.Two independent reviewers conducted data extraction, with discrepancies resolved by consensus.A meta-analysis was performed on the pooled data from eligible comparative studies.Results: Seventeen comparative studies were included in the analysis.No significant differences were observed between the E-TLIF and MIS-TLIF groups in leg pain VAS, ODI, and complication rates.However, postoperative VAS scores for back pain were significantly lower in the E-TLIF group than in the MIS-TLIF group.Conclusions: E-TLIF showed similar outcomes to MIS-TLIF in terms of leg pain, disability, and complications, with less postoperative back pain.Further multicenter studies are warranted to validate these findings.