Object:

Lateral Lumbar Interbody Fusion (LLIF) and percutaneous posterior screw fixation (PPSF) techniques is used to treat degenerative lumbar pathologies. Dual position (DP) lumbar surgery involves repositioning the patient from the supine or lateral decubitus position to prone for posterior fixation. Single-position (SP) lumbar surgery (LS) is commonly performed nowadays, minimally invasive alternative performed entirely from the lateral decubitus position. However, there is still controversial. This meta-analysis aimed to compare peri-operative outcomes between SPLS and DPLS for LLIF and PPSF.

Methods:

We conducted this meta-analysis according to the PRISMA guidelines and searched Medline and Scopus from inception to November 11, 2021 for relevant studies.

Results:

Six studies were identified, which contained totals of 502 and 447 patients in the SP and DP groups, respectively. The unstandardized mean difference in operative time, length of hospital stay, intraoperative blood loss, radiation doses, lumbar lordosis, and PI-LL mismatch were -86.1 (95%CI: -149.2 to -23.1) minutes, -1.6 (95%CI: -2.4 to -0.9) days, -55.6 (95%CI: -127.5 to 16.2) ml, -30.3 (95%CI: -80.5 to 19.8) mGy, 1.34 (95%CI: -1.17 to 3.86) degree, and -4.06 (95%CI: -5.65 to -2.47) lower in SP when compared to DP. The chances of having complications and reoperations in SP were 0.75 (95%CI: 0.49 to 1.14) and 0.77 (95%CI: 0.44 to 1.36) times, respectively, compared to DP group. No significant differences were found for intraoperative blood loss, radiation dose, lumbar lordosis, complications and re-operations between two groups.

Conclusion:

This meta-analysis found that SP have lower operative time and length of hospital stay compared to DP LLIF and PPSF. However, no differences in intraoperative blood loss, radiation dose, radiographic change, complications, and re-operation rates were found.