Preliminary study of unilateral biportal endoscopic lumbar interbody fusion for the treatment of degenerative spinal disease

English Keywords:Endoscope  Lumbar interbody fusion  Degenerative spinal disease

English Abstract:

  【Abstract】 Objectives: To investigate the clinical efficacy of unilateral biportal endoscopic lumbar interbody fusion(ULIF) in the treatment of single-segment lumbar degenerative diseases. Methods: Retrospective analysis of 76 patients with single-segment lumbar degenerative disease admitted from August 2018 to May 2020. Among them, 35 cases were treated by ULIF(ULIF group) and 41 cases were treated by minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)(MIS-TLIF group). There were 16 males and 19 females in the ULIF group, with a mean age of 50.94±12.12 years; there were 19 males and 22 females in the MIS-TLIF group, with a mean age of 53.44±14.37 years. The operative time, intraoperative bleeding, postoperative hospital stay, complications were compared between the two groups. The visual analogue scale(VAS) and Oswestry disability index(ODI) of low back pain and leg pain before surgery, 2 weeks after surgery, 3 months after surgery, and at the final follow-up were measured, as well as fusion rate and modified Macnab criteria at the final follow-up. Results: All patients completed the surgery successfully. Compared with the MIS-TLIF group, the ULIF group had less intraoperative bleeding(52.03±11.48ml vs 134.46±18.63ml, P＜0.05) and a shorter postoperative hospital stay(8.43±1.88d vs 9.98±1.96d, P＜0.05). In both groups, VAS score and ODI decreased significantly after surgery compared with those before surgery, and the VAS score of low back pain in the ULIF group at 2 weeks postoperatively was 3.06±1.41, which was significantly lower than that of the MIS-TLIF group(4.10±1.64), and the ODI of the ULIF group at 2 weeks postoperatively was(32.20±4.32)%, which was significantly lower than that of the MIS-TLIF group(37.11±4.72)%, and the difference was statistically significant(P＜0.05). The fusion rate at the final follow-up was 88.6% in the ULIF group and 90.2% in the MIS-TLIF group, with no statistically significant difference between the two groups(P>0.05). The excellent rate of modified MacNab criteria at the final follow-up was 91.4%(32/35) in the ULIF group and 87.8%(36/41) in the MIS-TLIF group, with no significant difference between the two groups(P>0.05). Conclusions: Compared with MIS-TLIF, ULIF has the advantages of less intraoperative bleeding, less early postoperative back pain, shorter postoperative hospital stay and faster early functional recovery in the treatment of lumbar degenerative disease.