Abstract
Purpose
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Transforaminal lumbar interbody fusion (TLIF) is a classic surgical procedure for posterior lumbar fusion. This study aims to analyze the TLIF field by bibliometric method and comprehensively summarize the research status and trends.
Methods
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All TLIF-related articles were retrieved from the Web of Science. The data were analyzed using R software and SPSS to calculate corresponding indicators. Visualizations were drawn using VOSviewer and Scimago Graphica, including country, institution, journal, author, and keywords.
Results
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A total of 919 articles were included. The annual publication volume of TLIF-related articles presented an exponential growth. North America, Europe, and Asia were the main sources of articles, with the USA and China being the main contributors and the USA being the global research center for TLIF. The level of the national economy was an important factor affecting TLIF-related research. The highest number of contributions in this field was made by Kern Singh among authors and by Rush University among institutions. The European Spine Journal was the most influential journal. The research focus has gradually shifted from perfecting the TLIF technique toward emphasizing the patient level. The improvement of minimally invasive techniques and how to improve clinical outcomes as well as accelerate postoperative rehabilitation of patients may be the hot spot of future research.
Conclusions
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With the advancement of medical technology and the popularization of minimally invasive concepts in recent years, TLIF and its derivative technologies have attracted increasing attention. Patient-centered minimally invasive surgery is a hot research topic in the field of TLIF currently and will continue to be so into the future
Introduction
Lumbar interbody fusion (LIF) is an effective procedure for treating lumbar disorders, including degenerative disease, trauma, infection, and tumors (1). Based on the different surgical approaches, LIF can be roughly classified into five main branches: posterior approaches of posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), anterior approaches of anterior lumbar interbody fusion (ALIF), extreme/direct lateral interbody fusion (XLIF/DLIF), and oblique lateral interbody fusion (OLIF). Both anterior and posterior LIF procedures involve removing the intervertebral disc, inserting interbody cage and graft materials, as well as internal fixation between the vertebral bodies. Previous studies have shown that both approaches can achieve satisfactory fusion rates with similar clinical outcomes (2). However, the advantages and disadvantages of different approaches to LIF are not equal. For example, the classic anterior approach of ALIF and the lateral approach of OLIF have the advantages of direct access to the intervertebral disc, without disturbing the spinal canal. Surgeons can handle the disc under direct vision and place larger interbody cages, resulting in better restoration of disc height and lumbar lordosis. However, those approaches require familiarity with abdominal anatomy. The risks of complications associated with the approaches, such as injury to major vessels, incisional hernias, and retrograde ejaculation, are significantly higher than posterior approaches, and the learning curves are steeper. Furthermore, both anterior and lateral interbody fusion are indirect decompression, which may result in a risk of incomplete decompression for radiculopathy caused by disc herniation and severe spinal stenosis, limiting the indications for surgery. In contrast, surgeons are more familiar with the posterior anatomy, resulting in the learning curve being relatively flat, which provides advantages in reducing operation time and hospital stay. Moreover, posterior surgery provides direct decompression and has a wider range of indications. However, due to its requiring entry into the spinal canal, the risk of dural injury is relatively higher, and the ability to correct sagittal imbalance and restore lumbar lordosis is inferior to anterior or lateral surgery (3, 4).
Since Harms et al. first reported in 1982, TLIF has gradually become one of the classic surgical procedures for posterior lumbar fusion with its reliable safety and effectiveness, and has achieved significant clinical outcomes. Compared to PLIF, TLIF can preserve the contralateral posterior column structure and reduce soft tissue injury, resulting in a smaller impact on the spinal biomechanical stability and thus favoring patients’ postoperative rehabilitation. In recent years, the number of TLIF procedures has significantly increased globally, which may be attributed to the development of TLIF driven by advances in surgical techniques and medical devices, as well as the increasing incidence of degenerative lumbar diseases caused by aging population (5). Currently, numerous scholars have conducted in-depth research on the safety, effectiveness, and clinical outcomes of TLIF and its derivative procedures, and have published lots of high-quality articles. However, in view of the steep learning curve of the TLIF, particularly the minimally invasive TLIFs that have emerged in recent years, beginners often require significant learning investment during the initial learning phase. Meanwhile, in recent years, due to the rapid development of nonfusion minimally invasive spine surgeries represented by transforaminal endoscopy, and other technologies such as ALIF and OLIF, it remains to be seen whether the development direction and research hot spots of TLIF have changed.
Bibliometric analysis is a quantitative method for analyzing published literature, which is an effective tool for evaluating the current state and prospects of research in a specific field. In the field of TLIF, bibliometric analysis can provide an in-depth understanding of the basic knowledge structure, including the authors, countries, institutions, journals, hot topics and trends of research.
This study is the first to employ the bibliometric method to analyze the TLIF field, providing a comprehensive overview of the current research status in this area. It highlights the main research hot spots and clarifies the future research directions, aiming to provide assistance to researchers and surgeons, especially beginners, in quickly getting started in this field.
Materials and methods
Search strategy
All the data for this study was retrieved from the Web of Science Core Collection (WoSCC) database. The search keywords were identified as ‘Transforaminal Lumbar Interbody Fusion OR TLIF’ with the article type limited to ‘Article’ or ‘Review’ and the language restricted to English, with no restrictions on the publication date.
Tools
The data was processed and analyzed using R software, VOSviewer, Scimago Graphica, IBM SPSS Statistics 26, and Microsoft Excel 2016. The bibliometrix package in R software was used for statistical analysis and calculation of relevant impact indicators such as citation frequency, H-index, and G-index. VOSviewer is a data analysis and visualization tool based on the Java platform, commonly used for bibliometric data analysis and graphical visualization. Similarly, Scimago Graphica can also be used for graphical visualization and complements VOSviewer. We used the above software to conduct bibliometric analysis and visualizations of year, country, institution, journal, author, and keyword.
Data extraction
The search was conducted on February 16, 2023. Two authors independently verified the search results, removed any irrelevant ones, and discussed any discrepancies until a consensus was reached. A total number of 919 articles were included, and the publication year, country, institution, journal, author, keywords, as well as citation frequency were extracted and recorded for further analysis (Fig. 1).
Flowchart of the screening process for TLIF-related publications.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
Results
Publication trend
A total of 919 TLIF-related articles were identified from the WoSCC database, consisting of 847 Original Articles and 72 Reviews (Fig. 1). All articles were published between 2008 and 2023, and the annual publication volume showed an exponential growth (R 2 = 0.9713), with an average of 61 articles per year from 2008 to 2022. The year 2013 saw the fastest year-on-year increase in publication volume (43%), while 2018 to 2022 were the top 5 years with the most publications, indicating that TLIF-related research has been attracting increasing attention in recent years (Fig. 2).
Trends in TLIF-related publications from 2008 to 2023.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
Country distribution
All articles were published from 46 different countries. China (339 articles; 3846 citations) and the USA (310 articles; 7282 citations) were the two countries that contributed the most to the TLIF field, accounting for 70.2% of the total number of articles and 69.3% of the total citations (Table 1). Coauthorship between countries was analyzed using VOSviewer and Scimago Graphica software. Lines indicated the existence of co-authorship between countries, and the thickness of the lines reflected the strength of cooperation. It was obvious that North America, Europe, and Asia were the main sources of TLIF-related articles from Fig. 3 and 4, and the USA was the global research center for TLIF which had close cooperation with China (Fig. 3 and 4). In addition, this study found a significant linear correlation between a country's publication output and GDP level (R 2 = 0.953, P<0.01).
Contribution and co-authorship network of countries. The size of the nodes reflected the number of publications from each country.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
Network diagram of co-authorship between countries. The shape area represented the number of publications from each country.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
Top ten countries in terms of publication volume.
| Rank | Country | Publications | Total citations | Mean citations | H-index |
|---|---|---|---|---|---|
| 1 | China | 339 | 3846 | 11.38 | 30 |
| 2 | USA | 310 | 7282 | 23.57 | 46 |
| 3 | South Korea | 60 | 1209 | 20.15 | 19 |
| 4 | Japan | 39 | 701 | 17.97 | 14 |
| 5 | Singapore | 22 | 559 | 25.41 | 9 |
| 6 | Germany | 21 | 266 | 12.67 | 10 |
| 7 | India | 14 | 165 | 11.79 | 7 |
| 8 | Turkey | 13 | 99 | 7.62 | 5 |
| 9 | France | 11 | 225 | 20.45 | 6 |
| 10 | Australia | 9 | 401 | 44.56 | 7 |
Further analysis of annual publication output of each country revealed that the USA had been dominant in the field until 2021. In contrast, China experienced a relatively rapid growth period since 2015 (average annual growth rate from 2015 to 2022: China 26.0% vs the USA 17.2%) and surpassed the USA for the first time in 2021, becoming the country with the highest number of publications in the field (Fig. 5).
Annual number of publications in the top ten countries.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
Institution distribution
In total, 907 institutions participated in the publication of TLIF-related articles. Figure 6 showed the top ten institutions in terms of publication volume. Among them, five institutions were in China (Army Medical University, Shanghai Jiao Tong University, Tongji University, Fudan University, and Shandong University), three in the USA (Rush University, University of Michigan, and Northwestern University), and the remaining two were in Singapore (Singapore General Hospital) and Japan (Yonsei University), respectively. In terms of publication volume, total citation frequency, and H-index, Rush University had an absolute advantage over other institutions and had become the most contributing institution in the field. In addition, the institution with the highest average citation frequency was Vanderbilt University (89.00 times; USA), followed by University of California San Francisco (46.50 times; USA) and Wooridul Spine Hospital (41.20 times; South Korea).
Contribution of the top ten institutions in terms of publication volume. The ‘Total Citations’ in the figure was calculated by dividing the actual value by 10.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
We used VOSviewer to construct a network visualization graph to analyze the co-authorship relationship between institutions (Fig. 7A). The same color represents the same cluster, and the thickness of the lines between institutions represents the strength of collaboration. University of California San Francisco, Norton Leatherman Spine Center, Duke University, etc., formed the main clusters and collaborated extensively with other institutions. The co-authorship strength between Singapore General Hospital and Mount Elizabeth Medical Centre was the strongest, indicating that the two institutions may have highly similar research directions. Overlay visualizations were constructed to analyze the changes of the major research institutions over time (Fig. 7B). Twin Cities Spine Center and Wooridul Spine Hospital were the main institutions conducting TLIF research in the early stages (around 2011), while Qingdao University, Chulalongkorn University, and Weill Cornell Medical College had become the primary force in recent years (around 2021). In addition, about 63% of the major research institutions in recent years (marked in yellow or close to yellow) were affiliated with China, accounting for the rapid growth of China's publication volume in recent years. It was worth noting that among the institutions with more than five publications, most of institutions were located in Asia (43 institutions) or North America (26 institutions), except for Universidade do Porto in Europe.
(A) Network visualization of institutional co-authorship. The size of the nodes indicated the total link strength of co-authorship with other institutions (B) Overlay visualization of institutions. The color of each node indicated the average publication year.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
Journal distribution
All articles related to TLIF were published in 127 academic journals. The top ten journals accounted for 50.6% of the total number of articles and 68.3% of the total citations (Table 2). The journal with the highest publication volume was World Neurosurgery (n = 109), followed by European Spine Journal (n = 62), Spine (n = 57), Journal of Neurosurgery: Spine (n = 51), and Clinical Spine Surgery (n = 51). Although World Neurosurgery had a significantly higher publication volume than other journals, the journals with the highest total citations and H-index were European Spine Journal (1940 citations; H-index = 25), Journal of Neurosurgery: Spine (1811 citations; H-index = 22), and Spine (1741 citations; H-index = 23). Among the top ten journals mentioned above, Neurosurgical Focus (IF = 4.332) and Spine Journal (IF = 4.297) had the highest impact factor (IF) and were both located in JCR Q1.
The top ten most productive journals.
| Rank | Journal | Publications | Total citations | Mean citations | H-index | Impact factor | JCR partition | Country |
|---|---|---|---|---|---|---|---|---|
| 1 | World Neurosurgery | 109 | 1291 | 11.84 | 20 | 2.21 | Q3 | USA |
| 2 | European Spine Journal | 62 | 1940 | 31.29 | 25 | 2.721 | Q2 | USA |
| 3 | Spine | 57 | 1741 | 30.54 | 23 | 3.241 | Q2 | USA |
| 4 | Journal of Neurosurgery: Spine | 51 | 1811 | 35.51 | 22 | 3.467 | Q2 | USA |
| 5 | Clinical Spine Surgery | 51 | 425 | 8.33 | 12 | 1.723 | Q3 | USA |
| 6 | Spine Journal | 42 | 1462 | 34.81 | 20 | 4.297 | Q1 | USA |
| 7 | Journal of Spinal Disorders & Techniques | 24 | 1005 | 41.88 | 18 | N/A | N/A | USA |
| 8 | Neurosurgical Focus | 24 | 771 | 32.13 | 16 | 4.332 | Q1 | USA |
| 9 | BMC Musculoskeletal Disorders | 23 | 306 | 13.30 | 8 | 2.562 | Q3 | UK |
| 10 | Global Spine Journal | 22 | 142 | 6.45 | 8 | 2.23 | Q3 | Germany |
The journals with more than ten articles were further analyzed by VOSviewer, and 24 journals were included. It was evident from the figure that Frontiers In Surgery, Neurospine, Global Spine Journal, and Journal of Orthopaedic Surgery and Research were the most prolific journals. Scholars who seek to stay abreast of the latest research developments in this field were encouraged to focus on these journals in particular (Fig. 8).
The evolution of major journals in the TLIF field over time. The color indicates the average publication year.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
Author distribution
In total, 3730 authors participated in the publication of TLIF-related articles. Kern Singh, from Rush University in the USA, made the most outstanding contributions to this field and had published a cumulative total of 56 articles as corresponding author, followed by Zhou Yue, from Army Medical University in China, and Park Paul, from University of Michigan in the USA (Table 3). It was noteworthy that the authors with the highest H- and G-indexes were still Kern Singh, Zhou Yue, and Park Paul, indicating that they had significant influence in the TLIF field. Among the top ten authors in terms of publication volume, seven were from the USA, two from China, and one from South Korea. The density visualization constructed by VOSviewer showed that Kern Singh had the highest total link strength, indicating his extensive collaboration with other authors and absolute authority in this field (Fig. 9).
Density visualization of authors. Higher density means higher total link strength.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
The top ten most productive authors.
| Author | Publications | Total citations | Mean citations | H-index | G-index | Institution | Country |
|---|---|---|---|---|---|---|---|
| Kern Singh | 56 | 628 | 11.2 | 13 | 23 | Rush University | USA |
| Yue Zhou | 20 | 499 | 25 | 10 | 20 | Army Medical University | China |
| Paul Park | 17 | 586 | 34.5 | 12 | 17 | University of Michigan | USA |
| Brittany E Haws | 15 | 129 | 8.6 | 7 | 10 | Rush University | USA |
| Benjamin Khechen | 13 | 126 | 9.69 | 7 | 10 | Rush University | USA |
| Jie Zhao | 12 | 180 | 15 | 7 | 12 | Shanghai Jiao Tong University | China |
| Nisheka N Vanjani | 12 | 13 | 1.08 | 2 | 3 | Rush University | USA |
| Michael Y Wang | 11 | 562 | 51.1 | 8 | 11 | Univ Miami | USA |
| Jin-Sung Kim | 11 | 232 | 21.1 | 8 | 11 | Catholic Univ Korea | South Korea |
| Richard G Fessler | 11 | 170 | 15.5 | 7 | 11 | Rush University | USA |
Highly cited literature
Table 4 provided detailed information on the top ten most cited articles in the TLIF field (Table 4). All articles were published around 2010, with citation frequencies ranging from 148 to 251. An analysis of the article themes revealed that minimally invasive TLIF was the primary direction of most research, with a comparison between minimally invasive TLIF and open TLIF being the most common research topic.
The top ten most cited articles.
| Authors | Year | Article Title | Total citations |
|---|---|---|---|
| Dhall et al. (51) | 2008 | Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up | 251 |
| Wong et al. (52) | 2008 | Neurologic impairment from ectopic bone in the lumbar canal: a potential complication of off-label PLIF/TLIF use of bone morphogenetic protein-2 (BMP-2) | 242 |
| Parker et al. (53) | 2011 | Utility of minimum clinically important difference in assessing pain, disability, and health state after transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis | 214 |
| Rihn et al. (54) | 2009 | Complications associated with single-level transforaminal lumbar interbody fusion | 192 |
| Lee et al. (55) | 2012 | Clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion | 185 |
| Shunwu et al. (56) | 2010 | Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Treatment of Degenerative Lumbar Diseases | 182 |
| Schizas et al. (57) | 2009 | Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience | 177 |
| Wang et al. (58) | 2010 | Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2 | 173 |
| Seng et al. (59) | 2013 | Five-Year Outcomes of Minimally Invasive Versus Open Transforaminal Lumbar Interbody Fusion A Matched-Pair Comparison Study | 165 |
| Parker et al. (60) | 2014 | Minimally Invasive versus Open Transforaminal Lumbar Interbody Fusion for Degenerative Spondylolisthesis: Comparative Effectiveness and Cost-Utility Analysis | 148 |
Keywords analysis and research interest
Keywords can reflect the research theme, while the evolution of high-frequency keywords can reveal the research hot spots and trends. By using VOSviewer to conduct a visual analysis of the keywords, with a minimum word frequency set to 10, a total of 149 high-frequency keywords were included for further analysis. All keywords were divided into six clusters, with the core keywords of each cluster being #1: ‘outcomes’, #2: ‘tlif’,’ #3: ‘anterior’, #4: ‘spondylolisthesis’, #5: ‘complications’, and #6: ‘pedicle screw’ (Fig. 10A). According to the main research topics of clusters, they can be summarized into four categories – #1 and #4: Clinical Outcomes, #2 and #6: Surgical Technique, #3: Surgical Efficacy, and #5: Surgical Safety. It was evident from the figure that the TLIF technique itself and the efficacy of TLIF in treating lumbar disorders were hot research topics. In addition, we created overlay visualization to analyze the trend of research hot spots over time (Fig. 10B). ‘Bone morphogenetic protein-2’, ‘reduction’, and ‘fixation’ were high-frequency keywords in early studies (around 2014), indicating that the early focus of TLIF research was on the technique itself, including bone graft materials, internal fixation methods, surgical efficacy, and the like. Of these, bone morphogenetic protein (BMP) was a popular direction in early studies. ‘Patient-reported outcomes’, ‘endoscopy’, and ‘olif’, on the other hand, have been the research hot spots in recent years (around 2020), which indicated that the focus of TLIF research may have gradually shifted from perfecting and developing TLIF technique to emphasizing outcomes at the patient level. Minimally invasive surgery and how to improve the clinical outcome of patients may be the focus of future research.
(A) Network visualization of keywords. Each cluster represented a sub-subject of the research, with node size indicating the frequency of the keyword occurrence. (B) Overlay visualization of keywords. The node color indicates the average publication year.
Citation: EFORT Open Reviews 8, 12; 10.1530/EOR-23-0155
Discussion
TLIF was developed by Harms and Rolinger on the basis of PLIF to address the potential risks such as nerve root injury, dural tear, and epidural fibrosis associated with PLIF. It has been widely used in the treatment of lumbar degenerative diseases and has become one of the classic lumbar fusion surgeries (6). TLIF involves removing the unilateral superior together with inferior articular processes and utilizing the intervertebral foramen space to achieve nerve root decompression and interbody cage implantation. This technique achieves reconstruction of the three-column structure while reducing the damage to the posterior column and adjacent vertebral biomechanical stability (7). There is no significant difference in fusion rate compared to PLIF, while TLIF has the advantages of shorter operative time and lower incidence of complications (8). In recent years, with the popularization of minimally invasive concepts and the development of medical technology and devices, TLIF derivative techniques such as minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF), and robot-assisted minimally invasive TLIF have emerged. These techniques have achieved good clinical efficacy in reducing iatrogenic injury, shortening hospital stays as well as improving clinical satisfaction, and have shortened the postoperative rehabilitation process, which matches the concept of enhanced recovery after surgery (ERAS) in recent years.
In this study, TLIF-related articles included in the WoSCC from 2008 to 2023 were analyzed by bibliometric approach. We statistically analyzed the publications from various countries, institutions, journals, and authors, calculated the corresponding influence indicators, and constructed a visual graphic analysis of the research status and trends. The learning curve for TLIF and its derivative technologies is relatively steep, posing significant challenges for beginners and requiring a substantial investment of time. Therefore, this study aims to provide an intuitive and systematic understanding of the basic knowledge structure and major research hot spots in the TLIF field, guiding subsequent theoretical learning and clinical practice to enable faster proficiency in TLIF techniques. Additionally, the analysis of research hot spots can offer references for researchers when formulating research proposals.
This study found an exponential increase in the number of TLIF-related publications since 2008 (Fig. 2), indicating that TLIF-related research has gained widespread attention among scholars in recent years. This may be related to the popularization of the minimally invasive concept and the development of medical devices and surgical techniques. As one of the classic procedures for lumbar interbody fusion, TLIF has been widely recognized by the medical profession for its good therapeutic effect and high safety (9). With the rapid popularization of the minimally invasive concept in recent years, more and more scholars focus on the combination of the minimally invasive concept with TLIF, aiming to minimize iatrogenic injuries as much as possible while ensuring clinical efficacy to accelerate the process of postoperative rehabilitation (10, 11). On this basis, TLIF-related publications continue to increase.
From the perspective of national contribution, both China and the USA far surpass other countries in terms of publication volume, total citations, and H-index, indicating that the two countries occupy a dominant position in the TLIF field (Table 1). Furthermore, China and the USA have engaged in close international cooperation, promoting their solid discourse power in the field (Fig. 3 and 4). This study found a significant positive correlation between national publication volume and GDP, with most articles published by high-GDP countries in North America, Europe, and Asia, indicating that TLIF research may be influenced by national economic levels. Actually, TLIF has been developed for more than 40 years since it was first proposed in 1982. However, limited by the development of medical materials and devices, MIS-TLIF was not formally proposed until 2002 (12). In recent years, popular lumbar interbody fusion techniques, such as PETLIF, OLIF, and robot-assisted MIS-TLIF, have relied on the innovation of medical equipment driven by scientific and technological progress. However, countries with low GDP invest far less in the medical field compared to high GDP countries, resulting in slower progress in medical research and insufficient training of senior researchers, which may also explain why most articles are published by high GDP countries (13). Additionally, Ravindra et al. conducted a meta-analysis on the global incidence of degenerative lumbar diseases (lumbar spondylolisthesis, disc degeneration, and lumbar stenosis) and found that Europe together with North America had the highest incidence rates, while Western Pacific region (including China and Japan) had the highest case volume, which may have also contributed to the development of TLIF-related research in these regions (14).
It was evident from Fig. 6 that Rush University was the most influential institution in the TLIF field. Notably, the average publication years of the top ten most influential institutions listed in Fig. 6 were around 2017. For scholars interested in recent developments in TLIF research, it may be beneficial to focus on the primary research directions and publications of the institutions marked in yellow in Fig. 8. On the other hand, scholars seeking to learn classic articles or research findings may benefit from focusing on the institutions marked in purple. Furthermore, the majority of institutions contributing to the TLIF field were from Asia or North America, and institutions from other continents could enhance their cross-national cooperation to promote their development in the field.
The analysis of journals can evaluate the impact of the journal in the TLIF field, which can serve as one of the indicators for assessing the quality of articles as well as helping researchers to select suitable journals for their research findings. Among the top ten journals in terms of publication volume, Neurosurgical Focus and Spine Journal had the highest impact, indicating their high reputation and authority in the TLIF field. It was worth noting that the journals with the highest H-index were European Spine Journal, Spine, and Journal of Neurosurgery: Spine, which indicated that these three journals also had a significant influence in this field. Additionally, although East Asia was one of the main contributors to the TLIF field, there were few influential journals, and most of the high-impact journals were affiliated with the USA. Therefore, this study suggested that Asian countries can strengthen the development of international journals to further enhance their academic influence. Based on the overlay visualization of major journals (Fig. 8), it is apparently that World Neurosurgery, Clinical Spine Surgery, and Global Spine Journal were highly influential journals with a high publication volume in recent years, thus researchers can refer to this when selecting an appropriate journal for their TLIF-related research.
The analysis of authors can identify influential researchers and teams, which is helpful in promoting communication and cooperation among the authors. In addition, the viewpoints of high-impact authors may promote the research trend and provide powerful references for other researchers in developing research direction and plans. Kern Singh (Rush University, USA) had made the greatest contribution to the TLIF field, ranking first in terms of publication volume, H-index, and G-index, and had extensive and close cooperation with other authors (Table 3 and Fig. 9), indicating his tremendous academic influence in TLIF field. Analysis of the latest research findings of Kern Singh and his team revealed that the influencing factors of clinical outcomes after TLIF together with the efficacy comparison between MIS-TLIF and ALIF were the main research directions of his team in recent years. This is consistent with the previous speculation that the research focus has shifted toward improving patient clinical outcomes. Kern Singh and his team found that hospitalized patients, patients with milder preoperative lower extremity pain and patients with shorter preoperative symptom duration may achieve better clinical outcomes (15, 16, 17). On the other hand, patients with severe preoperative disability, significant low back pain, low mental functioning, and higher degrees of obesity (BMI ≥ 30) tend to have worse clinical outcomes (18, 19, 20, 21). ASA (American Society of Anesthesiologists) classification, severity of comorbidities, time to surgery (TTS), and duration of symptoms (DOS) had no significant impact on patient clinical outcomes (22, 23, 24). Notably, contrary to previous research that considered advanced age as an independent risk factor for TLIF, Kern Singh et al. suggested that age may not be a significant risk factor affecting the success of MIS-TLIF, as long as appropriate surgical inclusion criteria were followed (25, 26). In addition, Kern Singh and his team compared the clinical outcomes of patients undergoing MIS-TLIF or ALIF for isthmic spondylolisthesis and revision, and found that ALIF only significantly increased operative time and intraoperative blood loss, whereas there was no significant difference in long-term clinical outcomes between the two procedures (27, 28). As representative procedures for anterior and posterior lumbar fusion, ALIF and TLIF have been widely used for the treatment of lumbar disorders. However, there were few prospective randomized controlled studies that compare the clinical efficacy of the two procedures (29). Previous studies had shown that there was no significant difference between ALIF and TLIF in terms of fusion rate, but ALIF had a significantly higher incidence of vascular injury and a lower incidence of dural injury than TLIF (2). In addition, ALIF had been considered to significantly restore disc height and achieve sufficient foramen indirect decompression (30). Different from previous studies that focused on clinical indicators such as fusion rate and complication rate, recent studies by Kern Singh et al. have focused on clinical outcomes, minimum clinically important difference (MCID), and other patient indicators, indicating a shift in their research focus from clinical to patient perspective, which may also be in line with the trend of TLIF research. As can be seen from Fig. 10, the collaboration between the author teams was mainly concentrated in the teams of Kern Singh, Nisheka Vanjani, Nathaniel Jenkins et al. It is recommended that other teams can strengthen cooperation to collectively promote the development of the TLIF field.
Keyword clusters can reflect the research topics and hot spots in the field. Since its initial proposal, TLIF has been continuously developed toward the direction of minimally invasive surgery under in-depth research and refinement by numerous scholars. Traditional open TLIF has a satisfactory fusion rate. However, like other posterior open surgeries, open TLIF requires extensive dissection and retraction of the paravertebral soft tissue, which can increase intraoperative blood loss and the risk of fusion disease (31). MIS-TLIF is a combination of traditional TLIF and minimally invasive techniques aiming to reduce iatrogenic injury, accelerate postoperative rehabilitation and improve clinical outcome (32). MIS-TLIF has been proved to achieve a similar fusion rate comparable to traditional TLIF, while preserving the physiological function of paravertebral soft tissues, reducing the incidence of postoperative low back pain, shortening hospital stay, and improving patient quality of life (33). In addition, MIS-TLIF has also been proved to be suitable for obese patients and can achieve the same clinical efficacy as patients with normal BMI (34). However, due to the limitations of small incisions, the placement of percutaneous pedicle screws often relies on repeated intraoperative fluoroscopy adjustments, significantly increasing the risk of radiation exposure to surgeons and patients (35). As one of the hot spots of TLIF research, there is still no consensus on the selection of posterior internal fixation. Currently, there are four common methods of internal fixation: bilateral pedicle screw fixation (BPS), unilateral pedicle screw fixation (UPS), unilateral pedicle screw combined with contralateral translaminar facet joint screw fixation (UPS+TFS), and cortical bone trajectory (CBT) screw fixation. Among these, BPS is the most widely used single-segment fixation method in clinical practice, which can obtain rigid internal fixation on the three-column. However, the disadvantages of BPS include significant soft tissue injury during the screw placement, longer operation time, and increased risk of adjacent segment degeneration (ASD) due to the high stiffness of rigid internal fixation (36). UPS can simplify surgical procedures and reduce damage to the posterior column as well as adjacent vertebral bodies, but it is not sufficient to provide enough stability for the lumbar spine. After surgery, it can produce segmental off-axis movement and has a higher risk of cage migration and subsidence (37). To solve the shortcomings of these two internal fixation methods, researchers have innovated the UPS technique, aiming to increase its structural stability while retaining the advantages of UPS, thus UPS+TFS came into being. Compared with traditional BPS, UPS+TFS has more advantages in shortening operation time, reducing intraoperative blood loss and soft tissue injury, while its clinical efficacy and biomechanical stability are the same as BPS (38, 39). However, the long-term reliability of UPS+TFS is still lacking long-term follow-up verification, and the technique is cumbersome and requires higher surgical skills. Therefore, BPS is still the preferred method for posterior internal fixation. In recent years, with the rapid development of various TLIF auxiliary technologies such as O-arm fluoroscopy, navigation-assisted pedicle screw placement, and percutaneous pedicle screw fixation, the accuracy of pedicle screw insertion has significantly improved, which effectively saves operation time, reduces intraoperative radiation exposure, and is more conducive to the postoperative recovery (40, 41).
Since the first proposal of lumbar interbody fusion, autologous iliac crest bone graft (ICBG) has been regarded as the gold standard for interbody fusion. However, the iliac crest mainly consists of cancellous bone, which has inadequate resistance to pressure load and is prone to complications such as graft displacement and fusion failure, especially in patients with osteoporosis. Additionally, harvesting bone from the iliac crest requires a separate surgical incision, increasing the patient's burden and the risk of pain and infection at the donor site (42). Bone morphogenetic protein 2 (BMP-2), as a substitute for autologous iliac crest bone, has been widely used in clinical practice. Compared with ICBG, BMP-2 has advantages in improving fusion rate, reducing intraoperative blood loss, and shortening hospital stay, with no significant difference in the incidence of adverse events (43). However, high-dose BMP-2 significantly increases the risk of complications such as radiculitis and seroma (44). Furthermore, it is worth noting that previous studies have shown that BMP-2 may increase the risk of cancer, leading to catastrophic effects on patient prognosis (45). Further research is needed to explore the relationship between BMP and cancer. With the development of endoscopic techniques in recent years, PETLIF is gradually maturing and being applied in clinical practice. The advantages of PETLIF lie in the use of percutaneous endoscopic techniques via the Kambin triangle to achieve interbody fusion. Compared to MIS-TLIF, it has the benefits of less trauma, less blood loss, and shorter hospital stay, with no significant difference in fusion rate and clinical outcomes (46). Moreover, due to its minimally invasive nature, PETLIF has the potential to be performed under local anesthesia, allowing patients to remain conscious during surgery, thus enabling surgeons to obtain real-time feedback from patients and reducing the risk of nerve root injury (47). It can be said that the proposal of PETLIF is another big step in the minimally invasive road of TLIF. Like other minimally invasive techniques, PETLIF has a steep learning curve and requires higher surgical skills from the surgeon, making it challenging for beginners to master. Moreover, due to the limited space of Kambin triangle, PETLIF has higher requirements for the size and placement of the cage, requiring further development of surgical instruments. Meanwhile, with the improvement of endoscopic-assisted instruments, uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion (endo-TLIF) and unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) have also been actively carried out. Although they have not yet become mainstream procedures, it remains to be seen whether they will replace MIS-TLIF or become a powerful supplement to MIS-TLIF in the future. Due to its respective advantages and disadvantages, anterior and posterior lumbar fusion has always been a hot spot in LIF research. As one of the representative minimally invasive procedures for anterior lumbar fusion, OLIF has been widely used in clinical practice since its first proposal in 2012 and has achieved satisfactory therapeutic effects (48). OLIF establishes a working channel between the retroperitoneal vascular sheath and the anterior border of the psoas muscle, reducing damage to the surrounding structures and obtaining a larger operating space, which results in a better indirect decompression effect than posterior lumbar fusion. A recent meta-analysis showed that OLIF could achieve similar clinical outcomes to MIS-TLIF, including disc height restoration, hospital stay duration, visual analog scale (VAS) score, and Oswestry Disability Index (ODI) score, while having advantages in restoring lumbar lordosis and reducing intraoperative blood loss (49). However, OLIF has limitations of narrow indications and the inability to direct decompression. It should be noted that although there is no significant difference in complication rate between the two procedures, the main complications are not exactly the same, which may be attributed to different approaches.
Limitations
The main limitation of this study is that all data were obtained from the WoSCC database. As one of the most comprehensive and authoritative databases worldwide, WoSCC has been widely used in bibliometrics and is considered the optimal choice (50). However, we have found that some highly cited articles are not included in this database. Nonetheless, this does not affect our analysis of the TLIF field, as the work of individual authors may advance the research progress, but it does not have a qualitative impact on research trends. In addition, only English-language publications were included in this study, and influential non-English publications may have been omitted.
Conclusion
This study conducted a comprehensive bibliometric analysis of previous publications related to TLIF. The study has shown an exponential increase in TLIF-related publications, indicating that the relevant research was garnering increasing attention from experts and scholars. The USA and China had been the main contributors to this field, with the USA serving as the global research center for TLIF. The level of the national economy was an important factor affecting TLIF-related research. Professor Kern Singh and Rush University were the most prominent authors and institutions in this field, respectively. The European Spine Journal was the most influential journal in this field. The main focus of early research was to refine and develop the TLIF technique. With the growing popularity of minimally invasive concepts, the research focus had shifted toward patient-centered outcomes, and improving minimally invasive techniques, enhancing patient clinical outcomes, as well as accelerating postoperative rehabilitation may be the hot spots in future research.
Our study aims to help clinicians and researchers, especially beginners, understand the basic knowledge structure together with main research hot spots and trends in the TLIF field, providing a reference for their future mastery of TLIF techniques as well as development of related research proposals.
ICMJE Conflict of Interest Statement
The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the study reported.
Funding Statement
This study was supported in part by the Zhejiang Traditional Chinese Medicine Science and Technology Program (2023ZL256).
Author contribution statement
Conceptualization: XW, HQ, FF; Data Curation: XW, FF; Formal Analysis: XW, AZ; Funding Acquisition: FF; Methodology: XW, AZ; Project Administration: FF; Visualization: WY; Writing – Original Draft: XW; Writing – Review and Editing: FF, HQ.
References
- 1.↑
Resnick DK, Choudhri TF, Dailey AT, Groff MW, Khoo L, Matz PG, Mummaneni P, Watters WC, Wang J, Walters BC, et al.Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 7: intractable low-back pain without stenosis or spondylolisthesis. Journal of Neurosurgery. Spine 2005 2 670–672. (https://doi.org/10.3171/spi.2005.2.6.0670)
- 2.↑
Phan K, Thayaparan GK, & Mobbs RJ. Anterior lumbar interbody fusion versus transforaminal lumbar interbody fusion--systematic review and meta-analysis. British Journal of Neurosurgery 2015 29 705–711. (https://doi.org/10.3109/02688697.2015.1036838)
- 3.↑
Hsieh PC, Koski TR, O'Shaughnessy BA, Sugrue P, Salehi S, Ondra S, & Liu JC. Anterior lumbar interbody fusion in comparison with transforaminal lumbar interbody fusion: implications for the restoration of foraminal height, local disc angle, lumbar lordosis, and sagittal balance. Journal of Neurosurgery. Spine 2007 7 379–386. (https://doi.org/10.3171/SPI-07/10/379)
- 4.↑
Fleege C, Arabmotlagh M, Rother W, Rauschmann M, & Rickert M. ALIF and PLIF interposition in low-grade isthmic spondylolisthesis L5/S1 : longterm-Comparison of interbody fusion techniques (ALIF - PLIF). Der Orthopade 2016 45 760–769. (https://doi.org/10.1007/s00132-016-3311-4)
- 5.↑
Martin BI, Mirza SK, Spina N, Spiker WR, Lawrence B, & Brodke DS. Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015. Spine 2019 44 369–376. (https://doi.org/10.1097/BRS.0000000000002822)
- 6.↑
Harms J, & Rolinger H. Die operative Behandlung der Spondylolisthese durch dorsale Aufrichtung und ventrale Verblockung. Zeitschrift für Orthopädie und Ihre Grenzgebiete 2008 120 343–347. (https://doi.org/10.1055/s-2008-1051624)
- 7.↑
Audat Z, Moutasem O, Yousef K, & Mohammad B. Comparison of clinical and radiological results of posterolateral fusion, posterior lumbar interbody fusion and transforaminal lumbar interbody fusion techniques in the treatment of degenerative lumbar spine. Singapore Medical Journal 2012 53 183–187.
- 8.↑
Zhang Q, Yuan Z, Zhou M, Liu H, Xu Y, & Ren Y. A comparison of posterior lumbar interbody fusion and transforaminal lumbar interbody fusion: a literature review and meta-analysis. BMC Musculoskeletal Disorders 2014 15 367. (https://doi.org/10.1186/1471-2474-15-367)
- 9.↑
de Kunder SL, van Kuijk SMJ, Rijkers K, Caelers IJMH, van Hemert WLW, de Bie RA, & van Santbrink H. Transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a systematic review and meta-analysis. Spine Journal 2017 17 1712–1721. (https://doi.org/10.1016/j.spinee.2017.06.018)
- 10.↑
Lin GX, Park CK, Hur JW, & Kim JS. Time course observation of outcomes between minimally invasive transforaminal lumbar interbody fusion and posterior lumbar interbody fusion. Neurologia Medico-Chirurgica 2019 59 222–230. (https://doi.org/10.2176/nmc.oa.2018-0194)
- 11.↑
Patel AA, Zfass-Mendez M, Lebwohl NH, Wang MY, Green BA, Levi AD, Vanni S, & Williams SK. Minimally invasive versus open lumbar fusion: a comparison of blood loss, surgical complications, and hospital course. Iowa Orthopaedic Journal 2015 35 130–134.
- 12.↑
Foley KT, & Gupta SK. Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results. Journal of Neurosurgery 2002 97(Supplement) 7–12. (https://doi.org/10.3171/spi.2002.97.1.0007)
- 13.↑
Wen P, Luo P, Zhang B, & Zhang Y. Mapping knowledge structure and global research trends in gout: a bibliometric analysis from 2001 to 2021. Frontiers in Public Health 2022 10 924676. (https://doi.org/10.3389/fpubh.2022.924676)
- 14.↑
Ravindra VM, Senglaub SS, Rattani A, Dewan MC, Härtl R, Bisson E, Park KB, & Shrime MG. Degenerative lumbar spine disease: estimating global incidence and worldwide volume. Global Spine Journal 2018 8 784–794. (https://doi.org/10.1177/2192568218770769)
- 15.↑
Nie JW, Hartman TJ, Pawlowski H, Prabhu MC, Vanjani NN, Oyetayo OO, & Singh K. Impact of ambulatory setting for workers' compensation patients undergoing one-level minimally invasive transforaminal lumbar interbody fusion and review of the literature. World Neurosurgery 2022 167 e251–e267. (https://doi.org/10.1016/j.wneu.2022.07.136)
- 16.↑
Nie JW, Hartman TJ, MacGregor KR, Oyetayo OO, Zheng E, & Singh K. Does preoperative symptom duration impact clinical outcomes after minimally invasive transforaminal lumbar interbody fusion in the ambulatory setting? World Neurosurgery 2022 166 e599–e606. (https://doi.org/10.1016/j.wneu.2022.07.055)
- 17.↑
Jacob KC, Patel MR, Collins AP, Parsons AW, Prabhu MC, Vanjani NN, Pawlowski H, & Singh K. The effect of the severity of preoperative leg pain on patient-reported outcomes, minimum clinically important difference achievement, and patient satisfaction after minimally invasive transforaminal lumbar interbody fusion. World Neurosurgery 2022 167 e1196–e1207. (https://doi.org/10.1016/j.wneu.2022.09.004)
- 18.↑
Jacob KC, Patel MR, Collins AP, Ribot MA, Pawlowski H, Prabhu MC, Vanjani NN, & Singh K. The effect of the severity of preoperative disability on patient-reported outcomes and patient satisfaction following minimally invasive transforaminal lumbar interbody fusion. World Neurosurgery 2022 159 e334–e346. (https://doi.org/10.1016/j.wneu.2021.12.051)
- 19.↑
Jacob KC, Patel MR, Parsons AW, Vanjani NN, Pawlowski H, Prabhu MC, & Singh K. The effect of the severity of preoperative back pain on patient-reported outcomes, recovery ratios, and patient satisfaction following minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). World Neurosurgery 2021 156 e254–e265. (https://doi.org/10.1016/j.wneu.2021.09.053)
- 20.↑
Patel MR, Jacob KC, Patel SD, Prabhu MC, Vanjani NN, Pawlowski H, & Singh K. Influence of preoperative 12-item short form mental composite score on clinical outcomes in an isthmic spondylolisthesis population undergoing minimally invasive transforaminal lumbar interbody fusion. World Neurosurgery 2022 158 e1022–e1030. (https://doi.org/10.1016/j.wneu.2021.12.026)
- 21.↑
Cha EDK, Lynch CP, Mohan S, Geoghegan CE, Jadczak CN, & Singh K. Impact of obesity severity on achieving a minimum clinically important difference following minimally invasive transforaminal lumbar interbody fusion. Clinical Spine Surgery 2022 35 E267–E273. (https://doi.org/10.1097/BSD.0000000000001205)
- 22.↑
Lynch CP, Cha EDK, Geoghegan CE, Jadczak CN, Mohan S, & Singh K. Higher American society of anesthesiologists classification does not limit safety or improvement following minimally invasive transforaminal lumbar interbody fusion. Neurospine 2022 19 533–543. (https://doi.org/10.14245/ns.2142088.044)
- 23.↑
Jacob KC, Patel MR, Vanjani NN, Pawlowski H, Prabhu MC, Park GJ, Collins AP, & Singh K. Severe comorbidity burden does not influence postoperative clinical outcomes and trajectory for back pain, leg pain, physical function, or disability in patients undergoing minimally invasive transforaminal lumbar interbody fusion: cohort-matched analysis. World Neurosurgery 2022 164 e157–e168. (https://doi.org/10.1016/j.wneu.2022.04.058)
- 24.↑
Patel MR, Jacob KC, Lynch CP, Cha EDK, Patel SD, Prabhu MC, Vanjani NN, Pawlowski H, & Singh K. Impact of time to surgery for patients using workers' compensation insurance undergoing minimally invasive transforaminal lumbar interbody fusion: a preliminary analysis of clinical outcomes. World Neurosurgery 2022 160 e421–e429. (https://doi.org/10.1016/j.wneu.2022.01.038)
- 25.↑
Shi H, Zhou ZM, Xu ZY, Zhu L, Jiang ZL, Chen L, & Wu XT. Risk factors for increased surgical drain output after transforaminal lumbar interbody fusion. World Neurosurgery 2021 151 e1044–e1050. (https://doi.org/10.1016/j.wneu.2021.05.059)
- 26.↑
Mohan S, Cha EDK, Lynch CP, Geoghegan CE, Jadczak CN, & Singh K. Impact of advanced age on postoperative outcomes following transforaminal lumbar interbody fusion. Journal of the American Academy of Orthopaedic Surgeons 2021 29 e869–e879. (https://doi.org/10.5435/JAAOS-D-20-01382)
- 27.↑
Patel MR, Jacob KC, Pawlowski H, Prabhu MC, Vanjani NN, & Singh K. Single-level minimally invasive transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion for the surgical treatment of isthmic spondylolisthesis. Journal of the American Academy of Orthopaedic Surgeons 2022 30 e1382–e1390. (https://doi.org/10.5435/JAAOS-D-21-01152)
- 28.↑
Nie JW, Hartman TJ, Jacob KC, Patel MR, Vanjani NN, MacGregor KR, Oyetayo OO, Zheng E, & Singh K. Minimally Invasive transforaminal versus Anterior Lumbar interbody Fusion in Patients Undergoing Revision Fusion: clinical Outcome Comparison. World Neurosurgery 2022 167 e1208–e1218. (https://doi.org/10.1016/j.wneu.2022.09.003)
- 29.↑
Mobbs RJ, Phan K, Malham G, Seex K, & Rao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. Journal of Spine Surgery 2015 1 2–18. (https://doi.org/10.3978/j.issn.2414-469X.2015.10.05)
- 30.↑
Rao PJ, Maharaj MM, Phan K, Lakshan Abeygunasekara M, & Mobbs RJ. Indirect foraminal decompression after anterior lumbar interbody fusion: a prospective radiographic study using a new pedicle-to-pedicle technique. Spine Journal 2015 15 817–824. (https://doi.org/10.1016/j.spinee.2014.12.019)
- 31.↑
Gejo R, Matsui H, Kawaguchi Y, Ishihara H, & Tsuji H. Serial changes in trunk muscle performance after posterior lumbar surgery. Spine 1999 24 1023–1028. (https://doi.org/10.1097/00007632-199905150-00017)
- 32.↑
Chen YC, Zhang L, Li EN, Ding LX, Zhang GA, Hou Y, & Yuan W. An updated meta-analysis of clinical outcomes comparing minimally invasive with open transforaminal lumbar interbody fusion in patients with degenerative lumbar diseases. Medicine 2019 98 e17420. (https://doi.org/10.1097/MD.0000000000017420)
- 33.↑
Ozgur BM, Yoo K, Rodriguez G, & Taylor WR. Minimally-invasive technique for transforaminal lumbar interbody fusion (TLIF). European Spine Journal 2005 14 887–894. (https://doi.org/10.1007/s00586-005-0941-3)
- 34.↑
Lau D, Khan A, Terman SW, Yee T, La Marca F, & Park P. Comparison of perioperative outcomes following open versus minimally invasive transforaminal lumbar interbody fusion in obese patients. Neurosurgical Focus 2013 35 E10. (https://doi.org/10.3171/2013.5.FOCUS13154)
- 35.↑
Phan K, Rao PJ, Kam AC, & Mobbs RJ. Minimally invasive versus open transforaminal lumbar interbody fusion for treatment of degenerative lumbar disease: systematic review and meta-analysis. European Spine Journal 2015 24 1017–1030. (https://doi.org/10.1007/s00586-015-3903-4)
- 36.↑
Kyaw TA, Wang Z, Sakakibara T, Yoshikawa T, Inaba T, & Kasai Y. Biomechanical effects of pedicle screw fixation on adjacent segments. European Journal of Orthopaedic Surgery and Traumatology: Orthopedie Traumatologie 2014 24(Supplement 1) S283–S287. (https://doi.org/10.1007/s00590-014-1416-1)
- 37.↑
Slucky AV, Brodke DS, Bachus KN, Droge JA, & Braun JT. Less invasive posterior fixation method following transforaminal lumbar interbody fusion: a biomechanical analysis. Spine Journal 2006 6 78–85. (https://doi.org/10.1016/j.spinee.2005.08.003)
- 38.↑
Best NM, & Sasso RC. Efficacy of translaminar facet screw fixation in circumferential interbody fusions as compared to pedicle screw fixation. Journal of Spinal Disorders and Techniques 2006 19 98–103. (https://doi.org/10.1097/01.bsd.0000179244.76244.5e)
- 39.↑
Gong Z, Chen Z, Feng Z, Cao Y, Jiang C, & Jiang X. Finite element analysis of 3 posterior fixation techniques in the lumbar spine. Orthopedics 2014 37 e441–e448. (https://doi.org/10.3928/01477447-20140430-54)
- 40.↑
Safaee M, Oh T, Pekmezci M, & Clark AJ. Cone beam intraoperative computed tomography-based image guidance for minimally invasive transforaminal interbody fusion. Journal of Visualized Experiments: JoVE 2019 150 e57830. (https://doi.org/10.3791/57830)
- 41.↑
Chen K, Chen H, Zhang K, Yang P, Sun J, Mo J, Zhou F, Yang H, & Mao H. O-arm navigation combined with microscope-assisted MIS-TLIF in the treatment of lumbar degenerative disease. Clinical Spine Surgery 2019 32 E235–E240. (https://doi.org/10.1097/BSD.0000000000000804)
- 42.↑
Heary RF, Schlenk RP, Sacchieri TA, Barone D, & Brotea C. Persistent iliac crest donor site pain: independent outcome assessment. Neurosurgery 2002 50 510–516. (https://doi.org/10.1097/00006123-200203000-00015)
- 43.↑
Mariscal G, Nunez JH, Barrios C, & Domenech-Fernández P. A meta-analysis of bone morphogenetic protein-2 versus iliac crest bone graft for the posterolateral fusion of the lumbar spine. Journal of Bone and Mineral Metabolism 2020 38 54–62. (https://doi.org/10.1007/s00774-019-01025-9)
- 44.↑
Khan TR, Pearce KR, McAnany SJ, Peters CM, Gupta MC, & Zebala LP. Comparison of transforaminal lumbar interbody fusion outcomes in patients receiving rhBMP-2 versus autograft. Spine Journal 2018 18 439–446. (https://doi.org/10.1016/j.spinee.2017.08.230)
- 45.↑
Carragee EJ, Hurwitz EL, & Weiner BK. A critical review of recombinant human bone morphogenetic protein-2 trials in spinal surgery: emerging safety concerns and lessons learned. Spine Journal 2011 11 471–491. (https://doi.org/10.1016/j.spinee.2011.04.023)
- 46.↑
Ao S, Zheng W, Wu J, Tang Y, Zhang C, Zhou Y, & Li C. Comparison of Preliminary clinical outcomes between percutaneous endoscopic and minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative diseases in a tertiary hospital: is percutaneous endoscopic procedure superior to MIS-TLIF? A prospective cohort study. International Journal of Surgery 2020 76 136–143. (https://doi.org/10.1016/j.ijsu.2020.02.043)
- 47.↑
Kolcun JPG, Brusko GD, Basil GW, Epstein R, & Wang MY. Endoscopic transforaminal lumbar interbody fusion without general anesthesia: operative and clinical outcomes in 100 consecutive patients with a minimum 1-year follow-up. Neurosurgical Focus 2019 46 E14. (https://doi.org/10.3171/2018.12.FOCUS18701)
- 48.↑
Silvestre C, Mac-Thiong JM, Hilmi R, & Roussouly P. Complications and morbidities of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lumbar interbody fusion in 179 patients. Asian Spine Journal 2012 6 89–97. (https://doi.org/10.4184/asj.2012.6.2.89)
- 49.↑
Wang J, Liu J, Hai Y, Zhang Y, & Zhou L. OLIF versus MI-TLIF for patients with degenerative lumbar disease: is one procedure superior to the other? A systematic review and meta-analysis. Frontiers in Surgery 2022 9 1014314. (https://doi.org/10.3389/fsurg.2022.1014314)
- 50.↑
Birkle C, Pendlebury DA, Schnell J, & Adams J. Web of Science as a data source for research on scientific and scholarly activity. Quantitative Science Studies 2020 1 363–376. (https://doi.org/10.1162/qss_a_00018)
- 51.↑
Dhall SS, Wang MY, & Mummaneni PV. Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up. Journal of Neurosurgery. Spine 2008 9 560–565. (https://doi.org/10.3171/SPI.2008.9.08142)
- 52.↑
Wong DA , Kumar A, Jatana S, Ghiselli G, & Wong K. Neurologic impairment from ectopic bone in the lumbar canal: a potential complication of off-label PLIF/TLIF use of bone morphogenetic protein-2 (BMP-2). Spine Journal 2008 8 1011–1018. (https://doi.org/10.1016/j.spinee.2007.06.014)
- 53.↑
Parker SL, Adogwa O, Paul AR, Anderson WN, Aaronson O, Cheng JS, & McGirt MJ. Utility of minimum clinically important difference in assessing pain, disability, and health state after transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis. Journal of Neurosurgery. Spine 2011 14 598–604. (https://doi.org/10.3171/2010.12.SPINE10472)
- 54.↑
Rihn JA, Patel R, Makda J, Hong J, Anderson DG, Vaccaro AR, Hilibrand AS, & Albert TJ. Complications associated with single-level transforaminal lumbar interbody fusion. Spine Journal 2009 9 623–629. (https://doi.org/10.1016/j.spinee.2009.04.004)
- 55.↑
Lee KH, Yue WM, Yeo W, Soeharno H, & Tan SB. Clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion. European Spine Journal 2012 21 2265–2270. (https://doi.org/10.1007/s00586-012-2281-4)
- 56.↑
Shunwu F, Xing Z, Fengdong Z, & Xiangqian F. Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases. Spine 2010 35 1615–1620. (https://doi.org/10.1097/BRS.0b013e3181c70fe3)
- 57.↑
Schizas C, Tzinieris N, Tsiridis E, & Kosmopoulos V. Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience. International Orthopaedics 2009 33 1683–1688. (https://doi.org/10.1007/s00264-008-0687-8)
- 58.↑
Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, & Liu J. Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. European Spine Journal 2010 19 1780–1784. (https://doi.org/10.1007/s00586-010-1404-z)
- 59.↑
Seng C, Siddiqui MA, Wong KP, Zhang K, Yeo W, Tan SB, Yue WM. Five-year outcomes of minimally invasive versus open transforaminal lumbar interbody fusion A matched-pair comparison study. Spine 2013 38 2049–2055. (https://doi.org/10.1097/BRS.0b013e3182a8212d)
- 60.↑
Parker SL, Mendenhall SK, Shau DN, Zuckerman SL, Godil SS, Cheng JS, & McGirt MJ. Minimally Invasive versus Open transforaminal Lumbar interbody Fusion for Degenerative spondylolisthesis: comparative Effectiveness and Cost-Utility Analysis. World Neurosurgery 2014 82 230–238. (https://doi.org/10.1016/j.wneu.2013.01.041)
