Comparative Study on Effectiveness of Unilateral Biportal Endoscopic Lumbar Interbody Fusion and Percutaneous Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion in the Treatment of Lumbar Degenerative Diseases.

Abstract

Retrospective clinical study. To study the differences in effectiveness of unilateral biportal endoscopic lumbar interbody fusion (ULIF) and percutaneous endoscopic posterolateral transforaminal lumbar interbody fusion (PE-PTLIF) in the treatment of lumbar degenerative diseases (LDD). While minimally invasive spine surgeries are gaining popularity, research on the comparative effectiveness of ULIF and PE-PTLIF remains limited. From January 2021 to January 2022, 52 patients with LDD were retrospectively recruited into the PE-PTLIF and ULIF groups. The operation time, true total blood loss, length of hospital stay, postoperative incision and drainage, postoperative complications, hospitalization cost, perioperative blood biochemical indexes, visual analog scale (VAS) score, Oswestry Disability Index (ODI), modified MacNab criteria, intervertebral disc height (DH), segmental lordosis (SL), lumbar lordosis (LL), dural sac cross-sectional area (DSCA), multifidus muscle fat infiltration score (MAIS) and multifidus muscle atrophy rate (MAR) were used as the evaluation indices. The surgical time, bleeding, and postoperative drainage volume in the PE-PTLIF group were less than those in the ULIF group. The average serum creatine kinase (CK), C-reactive protein (CRP), and hemoglobin (Hb) differences in the PE-PTLIF group were lower than those in the ULIF group on the first and third day after surgery. The VAS score of lower back pain and ODI (%) at 3 days and 1 month after surgery in the PE-PTLIF group were much lower than those in the ULIF group. At the last follow-up, the MAR and MAIS in the ULIF group were higher than in the PE-PTLIF group. PE-PTLIF has less damage to muscle and other soft tissues, faster recovery, but longer operation time. The incidence of complications of the 2 endoscopic-assisted lumbar fusions is less, and both are safe and effective surgical methods.