Unilateral Biportal Endoscopy or Minimally Invasive Surgery for Transforaminal Lumbar Interbody Fusion? A Comparative Cohort Study.

Abstract

The aim of this study was to compare the clinical and radiological results of transforaminal lumbar interbody fusion using unilateral biportal endoscopy (UBE-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of lumbar degenerative diseases. The study included 56 patients treated with UBE-TLIF or MIS-TLIF between June 2020 and June 2022. The visual analog scale (VAS) for leg and back pain and Oswestry Disability Index (ODI) score were evaluated. Intervertebral height and interbody fusion were measured by radiographic image. Duration of operation, blood loss, length of hospital stay, and complications were recorded. The VAS back and leg pain score, ODI, and intervertebral height improved significantly at all time points after surgery. No significant differences in the VAS leg pain score, ODI, and intervertebral height were observed between the groups at 7 days postoperatively and at the final follow-up. The VAS back pain score on postoperative day 7 was significantly higher in the MIS-TLIF group than in the UBE-TLIF group. However, there were no significant differences in the VAS back pain scores at the final follow-up between the groups. Blood loss was significantly lower in the UBE-TLIF group compared with the MIS-TLIF group, but no significant differences were observed in interbody fusion rate, operation time, length of hospital stay, and complications. Lower blood loss and less immediate postoperative pain were associated with UBE-TLIF compared with MIS-TLIF. UBE-TLIF is an alternative to and offers similar clinical and radiological results as MIS-TLIF for treating patients with lumbar degenerative disease.