“Early Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion Versus Minimal Invasive in the Treatment of Lumbar Degenerative Diseases”

Abstract

Study Design: This was a retrospective cohort study. Objective: To compare the early clinical efficacy and radiologic outcomes between unilateral biportal endoscopic lumbar interbody fusion (ULIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Summary of Background Data: Along with the continuous development of endoscopic technology, the early safety and effectiveness of ULIF technology are still unknown. Materials and Methods: This retrospective study included 61 patients who underwent fusion surgery through ULIF or MIS-TLIF in 2021. Twenty-nine patients underwent ULIF (group A), and 32 underwent MIS-TLIF (group B). Fusion rate, bone graft volume, hidden blood loss (HBL), C-reactive protein level, operative time, Oswestry Disability Index , Visual Analog Scale score, and MacNab criteria were assessed in both groups. Results: The Visual Analog Scale score for back pain in the early postoperative period was significantly lower in group A than in group B (P<0.05). All other clinical scores showed improvement, with no significant difference between the 2 groups (P>0.05). There was no statistically significant difference in postoperative C-reactive protein levels and fusion rates between the 2 groups (P>0.05). However, HBL was higher and operative time was longer in group A than in group B (P<0.05). Most importantly, there were no statistically significant differences between groups A and B in fusion rate, length of stay and bone graft volume (P>0.05). No serious surgical complications occurred in our study. Conclusions: ULIF is a new option for lumbar fusion. Despite the drawbacks of longer operation time and higher HBL, ULIF may be a viable alternative to MIS-TLIF as technology advances.