{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:55:13Z","timestamp":1782352513224,"version":"3.54.5"},"reference-count":65,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Because of heterogeneity in previous studies, the effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) on postoperative segmental lordosis (SL) and lumbar lordosis (LL) remains unclear. Given this evidence gap, the authors performed a systematic review and meta-analysis of studies reporting lordotic outcomes after single-level MI-TLIF. The authors also performed a meta-regression to identify preoperative factors associated with lordosis after surgery and assessed correlations between lordotic changes and patient-reported outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>In this systematic review, PubMed, Medline, CENTRAL, EMBASE, and Scopus were searched for studies describing single-level MI-TLIF for degenerative lumbar etiologies with at least 10 patients. Random-effects meta-analysis was used for data synthesis and I<jats:sup>2<\/jats:sup> was used to assess heterogeneity. Primary outcomes were changes in SL and\/or changes in overall LL.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Thirty-five studies comprising 1935 patients were included: 23 (66%) retrospective case series, 9 (26%) retrospective, and 3 (9%) prospective cohort studies. Twenty-five (71%) studies evaluated static interbody devices, 5 (14%) expandable devices, and 5 (14%) both device types. Thirty (86%) studies used bilateral pedicle screw fixation, 2 (6%) used unilateral screw fixation, and 3 (9%) included both techniques. The mean (range) sample size was 55 (13\u2013171) patients, mean \u00b1 SD age was 59.5 \u00b1 10.6 years, mean \u00b1 SD BMI was 26.9 \u00b1 4.6 kg\/m<jats:sup>2<\/jats:sup>, and mean \u00b1 SD (range) length of follow-up was 21.4 \u00b1 4.3 (6.0\u201363.7) months. On random-effects modeling, patients experienced a significant increase in SL (standardized mean difference [SMD] +2.2\u00b0, 95% CI 1.3\u00b0\u20133.1\u00b0, p &lt; 0.001) and overall LL (SMD +2.8\u00b0, 95% CI 0.8\u00b0\u20134.8\u00b0, p &lt; 0.001) at the latest follow-up. On meta-regression, preoperative SL (\u03b2 = \u22120.24\u00b0, 95% CI \u22120.42\u00b0 to \u22120.05\u00b0, p = 0.01) was predictive of a change in SL, whereas preoperative LL (\u03b2 = \u22120.53\u00b0, 95% CI \u22120.81\u00b0 to \u22120.25\u00b0, p = 0.009) and use of an expandable cage (\u03b2 = 6.56\u00b0, 95% CI 1.0\u00b0\u201312.2\u00b0, p = 0.02) were predictive of a change in LL. Univariable meta-regression found that greater increases in SL were associated with larger reductions in postoperative leg pain (\u03b2 = \u22121.03, 95% CI \u22121.6 to \u22120.45, p = 0.003); however, no significant associations were detected between changes in SL or LL and other clinical outcomes in either univariable or multivariable analyses.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Despite the significant heterogeneity among the included studies, these results suggest that single-level MI-TLIF is generally lordosis preserving, with preoperative alignment and interbody device type as possible predictors of postoperative lordosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2025.1.spine231363","type":"journal-article","created":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T02:18:08Z","timestamp":1746238688000},"page":"1-13","source":"Crossref","is-referenced-by-count":2,"title":["Segmental and overall lumbar lordosis after single-level minimally invasive transforaminal lumbar interbody fusion: a systematic review and meta-analysis"],"prefix":"10.3171","author":[{"given":"Justin K.","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"},{"name":"Department of Neurosurgery, Washington University, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim","family":"Yakdan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Washington University, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saksham","family":"Pruthi","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Saint Louis University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad I.","family":"Kaleem","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Washington University, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishtha","family":"Chavda","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Saint Louis University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxi","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Saint Louis University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazimir","family":"Bagdady","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Saint Louis University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Wegenka","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Saint Louis University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Koch","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Saint Louis University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"ReVeal","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Saint Louis University School of Medicine, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Public Health Sciences, Washington University, St. Louis, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher F.","family":"Dibble","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Atrium Health Wake Forest Baptist, Wake Forest, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob K.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Washington University, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Javeed","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Washington University, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Forrest A.","family":"Hamrick","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spencer","family":"Twitchell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Porche","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas T.","family":"Gamboa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon A.","family":"Sherrod","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Mahan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Dailey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus D.","family":"Mazur","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson Z.","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Washington University, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Neurosurg Spine","first-page":"416","article-title":"Perioperative outcomes and adverse events of minimally invasive versus open posterior lumbar fusion: meta-analysis and systematic review","volume":"24","author":"Goldstein CL","year":"2016","unstructured":"Goldstein CL, Macwan K, Sundararajan K, Rampersaud YR. 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