{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:53:34Z","timestamp":1777312414532,"version":"3.51.4"},"reference-count":128,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Degenerative lumbar spinal diseases are a leading cause of disability worldwide, often requiring surgical intervention when conservative management fails. Transforaminal lumbar interbody fusion (TLIF) is a commonly employed procedure to stabilize the spine and alleviate symptoms. This systematic review and meta-analysis aimed to test the safety and efficacy of robotic-assisted minimally invasive transforaminal lumbar interbody fusion (RA MIS-TLIF) in managing degenerative lumbar spinal diseases. Our primary objective was to compare the robotic approach with the conventional open or minimally invasive approach for TLIF regarding patients\u2019 perioperative and postoperative outcomes.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    PubMed, Cochrane Library, Scopus, and Embase were searched from inception until October 2023. The selection criteria included only English-language articles focused on human participants aged 18 years and older with measurable outcomes. Prospective and retrospective cohort studies were included. Relevant data regarding perioperative outcomes and postoperative pain scores were then extracted. Review Manager (RevMan) 5.4 was used for statistical analysis. No restrictions were applied regarding the surgical approach compared to the robotic approach. This review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Twelve observational studies, including 1,385 patients, were included in our final analysis. Robotic-assisted minimally invasive lumbar interbody fusion was associated with significantly lower blood loss compared to both open (MD: \u2212161.11 mL [95% CI, \u2212184.89 to \u2212137.34]) and conventional minimally invasive surgery (MD: \u221225.18 mL [95% CI, \u221264.06 to 13.70]), with an overall significant reduction (MD: \u221276.27 mL [95% CI, \u2212118.65 to \u221233.90]). Operative time was significantly longer in robotic surgery compared to non-robotic approaches (MD: 17.61 minutes [95% CI, 4.10 to 31.11]). Hospital stay was shorter in the robotic group than in the non-robotic surgery group (MD: \u22120.89 days [95% CI, \u22121.54, \u22120.24]). Radiation time and dose showed no significant differences. Postoperative pain and functional outcomes, including ODI and VAS scores, showed a trend toward improvement in the robotic group but did not reach statistical significance.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Robotic-assisted minimally invasive TLIF shows promising results in operative time and blood loss compared to open or minimally invasive TLIF.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2025.114","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T05:30:24Z","timestamp":1765431024000},"source":"Crossref","is-referenced-by-count":0,"title":["Robotic-assisted minimally invasive transforaminal lumbar interbody fusion: A meta-analysis of perioperative and postoperative outcomes"],"prefix":"10.5339","volume":"2025","author":[{"given":"Seif B.","family":"Altahtamouni","sequence":"first","affiliation":[{"name":"Orthopedic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loay A.","family":"Salman","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1161-7244","authenticated-orcid":true,"given":"Ahmad R.","family":"Al-Qudimat","sequence":"additional","affiliation":[{"name":"Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar"},{"name":"Public Health College, QU Health, Qatar University, Doha, Qatar*Correspondance: Ahmad R. Al-Qudimat aalqudimat@hamad.qa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar Fawaz","family":"Alnori","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"issue":"77 Suppl 4:","key":"B1","series-title":"Neurosurgery","first-page":"S1\u20135","article-title":"The aging of the global population: the changing epidemiology of disease and spinal disorders","author":"Fehlings\n \nMG","year":"2015"},{"key":"B2","series-title":"Z Orthop Ihre Grenzgeb","first-page":"343\u20137","article-title":"[A one-stage procedure in the operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author\u2019s transl)]","volume":"120","author":"Harms\n \nJ","year":"1982"},{"issue":"(12):","key":"B3","series-title":"Eur Spine J","first-page":"1991\u20132","article-title":"Surgery for degenerative lumbar disease: transforaminal lumbar interbody fusion","volume":"18","author":"Grob\n \nD","year":"2009"},{"issue":"(23):","key":"B4","series-title":"Spine (Phila Pa 1976)","first-page":"2049\u201355","article-title":"Five-year outcomes of minimally invasive versus open transforaminal lumbar interbody fusion: a matched-pair comparison study","volume":"38","author":"Seng\n \nC","year":"2013"},{"issue":"(6):","key":"B5","series-title":"Clin Orthop Relat Res","first-page":"1727\u20131737","article-title":"Comparative outcomes of minimally invasive surgery for posterior lumbar fusion: a systematic review","volume":"472","author":"Goldstein\n \nCL","year":"2014"},{"issue":"(2):","key":"B6","series-title":"Neurosurg Clin N Am","first-page":"279\u2013304","article-title":"Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF): surgical technique, long-term 4-year prospective outcomes, and complications compared with an open TLIF cohort","volume":"25","author":"Wong\n \nAP","year":"2014"},{"issue":"(8):","key":"B7","series-title":"Eur Spine J","first-page":"1741\u20139","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence","volume":"22","author":"Tian\n \nNF","year":"2013"},{"issue":"(6):","key":"B8","series-title":"Clin Orthop Relat Res","first-page":"1711\u20137","article-title":"Complications associated with the initial learning curve of minimally invasive spine surgery: a systematic review","volume":"472","author":"Sclafani\n \nJA","year":"2014"},{"issue":"(18):","key":"B9","series-title":"Spine (Phila Pa 1976)","first-page":"1548\u201357","article-title":"Learning curve and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion: our experience in 86 consecutive cases","volume":"37","author":"Lee\n \nJC","year":"2012"},{"key":"B10","series-title":"World Neurosurg","first-page":"472\u20138","article-title":"Learning curve and minimally invasive spine surgery","volume":"119","author":"Sharif\n \nS","year":"2018"},{"issue":"(17):","key":"B11","series-title":"Spine (Phila Pa 1976)","first-page":"1615\u201320","article-title":"Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases","volume":"35","author":"Shunwu\n \nF","year":"2010"},{"issue":"(4):","key":"B12","series-title":"Eur Spine J","first-page":"623\u20138","article-title":"Minimally invasive or open transforaminal lumbar interbody fusion as revision surgery for patients previously treated by open discectomy and decompression of the lumbar spine","volume":"20","author":"Wang\n \nJ","year":"2011"},{"issue":"(6):","key":"B13","series-title":"J Clin Neurosci","first-page":"829\u201335","article-title":"Minimally invasive surgery compared to open spinal fusion for the treatment of degenerative lumbar spine pathologies","volume":"19","author":"Mobbs\n \nRJ","year":"2012"},{"issue":"(20):","key":"B14","series-title":"Spine (Phila Pa 1976)","first-page":"2637\u201345","article-title":"Radiation exposure to the spine surgeon during fluoroscopically assisted pedicle screw insertion","volume":"25","author":"Rampersaud\n \nYR","year":"2000"},{"issue":"(5):","key":"B15","series-title":"Orthop Traumatol Surg Res","first-page":"597\u2013602","article-title":"Surgeon\u2019s and patient\u2019s radiation exposure during percutaneous thoraco-lumbar pedicle screw fixation: a prospective multicenter study of 100 cases","volume":"104","author":"Kouyoumdj\u00efan\n \nP","year":"2018"},{"issue":"(2):","key":"B16","series-title":"J Neurosurg Spine","first-page":"196\u2013203","article-title":"The accuracy of pedicle screw placement using intraoperative image guidance systems","volume":"20","author":"Mason\n \nA","year":"2014"},{"issue":"(6):","key":"B17","series-title":"Clin Biomech (Bristol)","first-page":"293\u2013303","article-title":"Clinical evaluation of a system for precision enhancement in spine surgery","volume":"10","author":"Nolte\n \nLP","year":"1995"},{"key":"B18","series-title":"Surg Neurol Int","first-page":"44","article-title":"Minimally invasive pedicle screw fixation utilizing O-arm fluoroscopy with computer-assisted navigation: feasibility, technique, and preliminary results","volume":"1","author":"Park\n \nP","year":"2010"},{"issue":"(6):","key":"B19","series-title":"Eur Spine J","first-page":"846\u201359","article-title":"Pedicle screw insertion accuracy with different assisted methods: a systematic review and meta-analysis of comparative studies","volume":"20","author":"Tian\n \nNF","year":"2011"},{"issue":"(7S):","key":"B20","series-title":"Spine","first-page":"S23","article-title":"The history of robotics in spine surgery","volume":"43","author":"Theodore\n \nN","year":"2018"},{"key":"B21","series-title":"Proc Inst Mech Eng H","first-page":"653\u201379","article-title":"A review of medical robotics for minimally invasive soft tissue surgery","volume":"224","author":"Dogangil\n \nG","year":"2010;"},{"issue":"(3):","key":"B22","series-title":"Neurosurg Focus","first-page":"E10","article-title":"Robotics and the spine: a review of current and ongoing applications","volume":"36","author":"Shweikeh\n \nF","year":"2014"},{"issue":"(2):","key":"B23","series-title":"Spine (Phila Pa 1976)","first-page":"87\u201394","article-title":"Monitoring the quality of robot-assisted pedicle screw fixation in the lumbar spine by using a cumulative summation test","volume":"40","author":"Kim\n \nHJ","year":"2015"},{"issue":"(24):","key":"B24","series-title":"Spine (Phila Pa 1976)","first-page":"2109\u201315","article-title":"Clinical acceptance and accuracy assessment of spinal implants guided with SpineAssist surgical robot: retrospective study","volume":"35","author":"Devito\n \nDP","year":"2010"},{"issue":"(5):","key":"B25","series-title":"J Neurosurg Spine","first-page":"615\u201322","article-title":"Safety and accuracy of robot-assisted versus fluoroscopy-assisted pedicle screw insertion in thoracolumbar spinal surgery: a prospective randomized controlled trial","volume":"30","author":"Han\n \nX","year":"2019"},{"issue":"(22):","key":"B26","series-title":"Medicine (Baltimore)","first-page":"e10970","article-title":"Accuracy of pedicle screw placement comparing robot-assisted technology and the free-hand with fluoroscopy-guided method in spine surgery: an updated meta-analysis","volume":"97","author":"Fan\n \nY","year":"2018"},{"issue":"(7):","key":"B27","series-title":"PLoS Med","first-page":"e1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher\n \nD","year":"2009"},{"issue":"(9):","key":"B28","series-title":"ANZ J Surg","first-page":"712\u20136","article-title":"Methodological index for non-randomized studies (minors): development and validation of a new instrument","volume":"73","author":"Slim\n \nK","year":"2003"},{"issue":"(1):","key":"B29","series-title":"Pain Physician","first-page":"E73\u20136","article-title":"Percutaneous Endoscopic Robot-Assisted Transforaminal Lumbar Interbody Fusion (PE RA-TLIF) for lumbar spondylolisthesis: a technical note and two-year clinical results","volume":"25","author":"Chang\n \nM","year":"2022"},{"issue":"(10):","key":"B30","series-title":"J Comp Eff Res","first-page":"845\u201356","article-title":"Robot-assisted minimally invasive transforaminal lumbar interbody fusion versus open transforaminal lumbar interbody fusion: a retrospective matched-control analysis for clinical and quality-of-life outcomes","volume":"10","author":"Chen\n \nX","year":"2021"},{"issue":"(7):","key":"B31","series-title":"Orthop Surg","first-page":"1960\u20138","article-title":"Robot-assisted minimally invasive transforaminal lumbar interbody fusion in the treatment of lumbar spondylolisthesis","volume":"13","author":"Cui\n \nGY","year":"2021"},{"key":"B32","series-title":"World Neurosurg","first-page":"e570\u20135","article-title":"Perioperative comparison of robotic-assisted versus fluoroscopically guided minimally invasive transforaminal lumbar interbody fusion","volume":"149","author":"De Biase\n \nG","year":"2021"},{"issue":"(4):","key":"B33","series-title":"Global Spine J","first-page":"450\u20137","article-title":"Radiation exposure in posterior lumbar fusion: a comparison of CT image-guided navigation, robotic assistance, and intraoperative fluoroscopy","volume":"11","author":"Wang\n \nE","year":"2021"},{"issue":"(1):","key":"B34","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Robot-guided versus freehand fluoroscopy-guided minimally invasive transforaminal lumbar interbody fusion: a single-institution, observational, case-control study","volume":"52","author":"Lin\n \nMC","year":"2022"},{"issue":"(2):","key":"B35","series-title":"J Minim Invasive Spine Surg Tech","first-page":"83\u20139","article-title":"Robotic assistance improves efficiency for navigated TLIF surgery","volume":"6","author":"Simonetta\n \nB","year":"2021;"},{"issue":"(5):","key":"B36","series-title":"J Neurosurg Spine","first-page":"741\u20137","article-title":"Index episode-of-care propensity-matched comparison of transforaminal lumbar interbsody fusion (TLIF) techniques: open traditional TLIF versus midline lumbar interbody fusion (MIDLIF) versus robot-assisted MIDLIF","volume":"32","author":"Ver\n \nMLP","year":"2020"},{"issue":"(2):","key":"B37","series-title":"J Robot Surg","first-page":"473\u201385","article-title":"Comparison of robot-assisted versus fluoroscopy-assisted minimally invasive transforaminal lumbar interbody fusion for degenerative lumbar spinal diseases: 2-year follow-up","volume":"17","author":"Wang\n \nL","year":"2023"},{"key":"B38","series-title":"Clin Neurol Neurosurg","first-page":"106698","article-title":"Operative time and learning curve between fluoroscopy-based instrument tracking and robot-assisted instrumentation for patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF)","volume":"206","author":"Wang\n \nTY","year":"2021"},{"key":"B39","series-title":"World Neurosurg","first-page":"e429\u201334","article-title":"Robot-assisted versus fluoroscopy-guided pedicle screw placement in transforaminal lumbar interbody fusion for lumbar degenerative disease","volume":"125","author":"Zhang\n \nQ","year":"2019"},{"issue":"(5):","key":"B40","series-title":"Orthop Surg","first-page":"850\u20136","article-title":"Comparison of superior-level facet joint violations between robot-assisted percutaneous pedicle screw placement and conventional open fluoroscopic-guided pedicle screw placement","volume":"11","author":"Zhang\n \nQ","year":"2019"},{"issue":"(2):","key":"B41","series-title":"Global Spine J","first-page":"151s\u2013167s","article-title":"Defining the MIS-TLIF: a systematic review of techniques and technologies used by surgeons worldwide","volume":"10","author":"Lener\n \nS","year":"2020"},{"issue":"(3S):","key":"B42","series-title":"Neurosurgery","first-page":"S86\u2013S99","article-title":"Navigation and robotics in spinal surgery: where are we now?","volume":"80","author":"Overley\n \nSC","year":"2017"},{"key":"B43","series-title":"Pain Res Manag","first-page":"6894001","article-title":"Accuracy of robot-assisted percutaneous pedicle screw placement under regional anesthesia: a retrospective cohort study","volume":"2021","author":"Gao\n \nS","year":"2021"},{"key":"B44","series-title":"World Neurosurg","first-page":"e635\u201345","article-title":"Robot-assisted versus freehand instrumentation in short-segment lumbar fusion: experience with real-time image-guided spinal robot","volume":"136","author":"Jiang\n \nB","year":"2020"},{"key":"B45","series-title":"Neurosurg Focus","first-page":"V4","article-title":"Integrating robotics into a minimally invasive transforaminal interbody fusion workflow","volume":"45","author":"Snyder\n \nLA","year":"2018"},{"issue":"(5):","key":"B46","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Current applications of robotics in spine surgery: a systematic review of the literature","volume":"42","author":"Joseph\n \nJR","year":"2017"},{"key":"B47","series-title":"Acta Neurochir Suppl","first-page":"241\u20135","article-title":"Robotic technology in spine surgery: current applications and future developments","volume":"109","author":"St\u00fcer\n \nC","year":"2011;"},{"issue":"(1):","key":"B48","series-title":"Spine (Phila Pa 1976)","first-page":"84\u201391","article-title":"Clinical accuracy of computer-assisted two-dimensional fluoroscopy for the percutaneous placement of lumbosacral pedicle screws","volume":"36","author":"Ravi\n \nB","year":"2011"},{"issue":"(5):","key":"B49","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Revisions for screw malposition and clinical outcomes after robot-guided lumbar fusion for spondylolisthesis","volume":"42","author":"Schr\u00f6der\n \nML","year":"2017"},{"issue":"(6):","key":"B50","series-title":"Spine (Phila Pa 1976)","first-page":"353\u20138","article-title":"Minimally invasive robotic versus open fluoroscopic-guided spinal instrumented fusions: a randomized controlled trial","volume":"42","author":"Hyun\n \nSJ","year":"2017"},{"issue":"(8):","key":"B51","series-title":"Spine (Phila Pa 1976)","first-page":"E496\u2013501","article-title":"Accuracy of robot-assisted placement of lumbar and sacral pedicle screws: a prospective randomized comparison to conventional freehand screw implantation","volume":"37","author":"Ringel\n \nF","year":"2012"},{"issue":"(6):","key":"B52","series-title":"J Neurosurg Spine","first-page":"636\u201343","article-title":"Safety and accuracy of robot-assisted versus fluoroscopy-guided pedicle screw insertion for degenerative diseases of the lumbar spine: a matched cohort comparison","volume":"20","author":"Schatlo\n \nB","year":"2014"},{"issue":"(3):","key":"B53","series-title":"Eur Spine J","first-page":"947\u201355","article-title":"Robot-assisted spine surgery: feasibility study through a prospective case-matched analysis","volume":"25","author":"Lonjon\n \nN","year":"2016"},{"issue":"(23):","key":"B54","series-title":"Spine (Phila Pa 1976)","first-page":"1670\u20137","article-title":"The arrival of robotics in spine surgery: a review of the literature","volume":"43","author":"Ghasem\n \nA","year":"2018"},{"issue":"(2 Suppl):","key":"B55","series-title":"Global Spine J","first-page":"137s\u2013142s","article-title":"Soft tissue: a possible source of pain pre and post minimally invasive spine surgery","volume":"10","author":"Marcus\n \nNJ","year":"2020"},{"issue":"(3):","key":"B56","series-title":"Spine (Phila Pa 1976)","first-page":"E191\u20138","article-title":"Quality-of-life outcomes with minimally invasive transforaminal lumbar interbody fusion based on long-term analysis of 304 consecutive patients","volume":"39","author":"Perez-Cruet\n \nMJ","year":"2014"},{"issue":"(24):","key":"B57","series-title":"Spine (Phila Pa 1976)","first-page":"2046\u201354","article-title":"Predictive factors of hospital stay in patients undergoing minimally invasive transforaminal lumbar interbody fusion and instrumentation","volume":"37","author":"Siemionow\n \nK","year":"2012"},{"issue":"(3):","key":"B58","series-title":"Neurospine","first-page":"216\u201324","article-title":"A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery","volume":"15","author":"Menger\n \nRP","year":"2018"},{"issue":"(1):","key":"B59","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Learning curves in robot-assisted spine surgery: a systematic review and proposal of application to residency curricula","volume":"52","author":"Pennington\n \nZ","year":"2022"},{"issue":"(10):","key":"B60","series-title":"Acta Neurochir (Wien)","first-page":"1819\u201323;","article-title":"Unskilled unawareness and the learning curve in robotic spine surgery","volume":"157","author":"Schatlo\n \nB","year":"2015"},{"key":"B61","series-title":"World Neurosurg","first-page":"e323\u20139","article-title":"Learning curve of robot-assisted percutaneous kyphoplasty for osteoporotic vertebral compression fractures","volume":"138","author":"Yuan\n \nW","year":"2020"},{"issue":"(6):","key":"B62","series-title":"Clin Orthop Relat Res","first-page":"1839\u201344","article-title":"What is the learning curve for robotic-assisted pedicle screw placement in spine surgery?","volume":"472","author":"Hu\n \nX","year":"2014"},{"issue":"(2):","key":"B63","series-title":"Neurosurg Focus","first-page":"E7","article-title":"Learning curve and complications of minimally invasive transforaminal lumbar interbody fusion","volume":"35","author":"Silva\n \nPS","year":"2013"},{"issue":"(7):","key":"B64","series-title":"J Spinal Disord Tech","first-page":"E234\u2013240","article-title":"Learning curve of a complex surgical technique: minimally invasive transforaminal lumbar interbody fusion (MIS TLIF)","volume":"27","author":"Lee\n \nKH","year":"2014"},{"issue":"77 Suppl 4:","key":"B1","series-title":"Neurosurgery","first-page":"S1\u20135","article-title":"The aging of the global population: the changing epidemiology of disease and spinal disorders","author":"Fehlings\n \nMG","year":"2015"},{"key":"B2","series-title":"Z Orthop Ihre Grenzgeb","first-page":"343\u20137","article-title":"[A one-stage procedure in the operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author\u2019s transl)]","volume":"120","author":"Harms\n \nJ","year":"1982"},{"issue":"(12):","key":"B3","series-title":"Eur Spine J","first-page":"1991\u20132","article-title":"Surgery for degenerative lumbar disease: transforaminal lumbar interbody fusion","volume":"18","author":"Grob\n \nD","year":"2009"},{"issue":"(23):","key":"B4","series-title":"Spine (Phila Pa 1976)","first-page":"2049\u201355","article-title":"Five-year outcomes of minimally invasive versus open transforaminal lumbar interbody fusion: a matched-pair comparison study","volume":"38","author":"Seng\n \nC","year":"2013"},{"issue":"(6):","key":"B5","series-title":"Clin Orthop Relat Res","first-page":"1727\u20131737","article-title":"Comparative outcomes of minimally invasive surgery for posterior lumbar fusion: a systematic review","volume":"472","author":"Goldstein\n \nCL","year":"2014"},{"issue":"(2):","key":"B6","series-title":"Neurosurg Clin N Am","first-page":"279\u2013304","article-title":"Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF): surgical technique, long-term 4-year prospective outcomes, and complications compared with an open TLIF cohort","volume":"25","author":"Wong\n \nAP","year":"2014"},{"issue":"(8):","key":"B7","series-title":"Eur Spine J","first-page":"1741\u20139","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion: a meta-analysis based on the current evidence","volume":"22","author":"Tian\n \nNF","year":"2013"},{"issue":"(6):","key":"B8","series-title":"Clin Orthop Relat Res","first-page":"1711\u20137","article-title":"Complications associated with the initial learning curve of minimally invasive spine surgery: a systematic review","volume":"472","author":"Sclafani\n \nJA","year":"2014"},{"issue":"(18):","key":"B9","series-title":"Spine (Phila Pa 1976)","first-page":"1548\u201357","article-title":"Learning curve and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion: our experience in 86 consecutive cases","volume":"37","author":"Lee\n \nJC","year":"2012"},{"key":"B10","series-title":"World Neurosurg","first-page":"472\u20138","article-title":"Learning curve and minimally invasive spine surgery","volume":"119","author":"Sharif\n \nS","year":"2018"},{"issue":"(17):","key":"B11","series-title":"Spine (Phila Pa 1976)","first-page":"1615\u201320","article-title":"Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases","volume":"35","author":"Shunwu\n \nF","year":"2010"},{"issue":"(4):","key":"B12","series-title":"Eur Spine J","first-page":"623\u20138","article-title":"Minimally invasive or open transforaminal lumbar interbody fusion as revision surgery for patients previously treated by open discectomy and decompression of the lumbar spine","volume":"20","author":"Wang\n \nJ","year":"2011"},{"issue":"(6):","key":"B13","series-title":"J Clin Neurosci","first-page":"829\u201335","article-title":"Minimally invasive surgery compared to open spinal fusion for the treatment of degenerative lumbar spine pathologies","volume":"19","author":"Mobbs\n \nRJ","year":"2012"},{"issue":"(20):","key":"B14","series-title":"Spine (Phila Pa 1976)","first-page":"2637\u201345","article-title":"Radiation exposure to the spine surgeon during fluoroscopically assisted pedicle screw insertion","volume":"25","author":"Rampersaud\n \nYR","year":"2000"},{"issue":"(5):","key":"B15","series-title":"Orthop Traumatol Surg Res","first-page":"597\u2013602","article-title":"Surgeon\u2019s and patient\u2019s radiation exposure during percutaneous thoraco-lumbar pedicle screw fixation: a prospective multicenter study of 100 cases","volume":"104","author":"Kouyoumdj\u00efan\n \nP","year":"2018"},{"issue":"(2):","key":"B16","series-title":"J Neurosurg Spine","first-page":"196\u2013203","article-title":"The accuracy of pedicle screw placement using intraoperative image guidance systems","volume":"20","author":"Mason\n \nA","year":"2014"},{"issue":"(6):","key":"B17","series-title":"Clin 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