Comparison of the clinical outcomes of unilateral biportal endoscopy versus minimally invasive transforaminal lumbar interbody fusion for the treatment of lumbar degenerative diseases with single- or two-segments

Abstract

Objectives Unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) is a new minimally invasive technique for intervertebral fusion under full endoscopy. We conducted a comprehensive comparative analysis with another minimally invasive technique (minimally invasive transforaminal lumbar interbody fusion, Mis-TLIF) in terms of surgical trauma, clinical outcomes, laboratory indicators. Methods A retrospective analysis of clinical and imaging data of 77 patients with lumbar degenerative illnesses(37 underwent UBE-TLIF, 40 underwent Mis-TLIF) was performed. Demographic data, clinical outcomes [visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI)], operative data (total operation time, intraoperative blood loss, postoperative drainage, length of hospital stay), and laboratory results [plasma hemoglobin (HB), serum creatine phosphokinase (CPK), and C-reactive protein (CRP) ] were compared between the two groups, The Macnab score, fusion rate and fusion time, and complications were also recorded. Results Both groups experienced significant improvements in VAS for back and leg pain and ODI scores after surgery (P < 0.05). The VAS-Back and ODI scores were significantly better in the UBE-TLIF group than in the Mis-TLIF group at 1 week and 1 month after surgery (P < 0.05). Although the total operation time was significantly longer in the UBE-TLIF group (P < 0.01), the intraoperative blood loss, postoperative drainage and decrease in hemoglobin level were significantly higher in the Mis-TLIF group (P < 0.01). A difference was observed in the fusion time (P < 0.05). There were no between-group differences for the fusion rate, postoperative complications, excellent and good rates and hospital stay (P > 0.05). Serum CRP and CPK levels were considerably lower in the UBE-TLIF group than in the MIS-TLIF group after surgery (P < 0.01). Conclusions Both UBE-TLIF and Mis-TLIF have equivalent and favorable clinical outcomes. UBE-TLIF is better in reducing surgical bleeding and rapidly improving postoperative back pain.