Zhu Zhicheng, He Banglin, Sun Jifu, Lin Liqun, Meng Chen, Sun Yan, Jiang Chao, Huang Yonghui
Jiangsu University, Zhenjiang, 212001, Jiangsu, China.
Affiliated Hospital of Yangzhou University, Yangzhou, 225000, China.
BMC Musculoskelet Disord. 2025 May 28;26(1):526. doi: 10.1186/s12891-025-08777-8.
This study retrospectively compared the early clinical and imaging outcomes of the single-level Meyerding Grade I degenerative lumbar spondylolisthesis (DLS) between unilateral biportal endoscopic lumbar interbody fusion (ULIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) using an expandable tubular retractor system under a surgical loupe.
This was a retrospective study. This study included fifty-five patients, with twenty-eight underwent ULIF and twenty-seven who underwent MI-TLIF at the Affiliated Hospital of Jiangsu University from June 2020 to July 2021. Demographic characteristic, surgical parameters, laboratory results, and clinical and imaging outcomes were collected and compared between the two groups.
In our retrospective study, the ULIF group was superior in terms of the mean total blood loss, intraoperative blood loss than MI-TLIF (P < 0.05). However, there was no statistically significant difference in hidden blood loss between the two groups (P > 0.05). Moreover, the mean operative time was significantly longer than in the ULIF group in the MI-TLIF group (P < 0.05). The mean CK and CRP levels on the first postoperative day were significantly lower in the ULIF group (P < 0.001). All clinical scores improved significantly after the operation in both groups. The VAS back score for pain at two weeks and 1 month postoperatively was significantly lower in the ULIF group (P < 0.05). There was no significant difference between the two groups in the change in the dural sac cross-sectional area preoperatively or at the final postoperative follow-up. The fusion rate was significantly greater in ULIF at 6 months after the operation (P < 0.05).
Compared to MI-TLIF, the ULIF technique has the advantages of less hemorrhage, less inflammation, and earlier fusion. However, this approach has a limited operation time. However, further clinical outcomes need to be followed up in the longer term.
本研究采用手术放大镜下可扩张管状牵开器系统，回顾性比较单侧双孔道内镜腰椎椎间融合术（ULIF）与微创经椎间孔腰椎椎间融合术（MI-TLIF）治疗单节段迈尔丁I度退变性腰椎滑脱症（DLS）的早期临床和影像学结果。
这是一项回顾性研究。本研究纳入了55例患者，其中28例行ULIF，27例行MI-TLIF，均于2020年6月至2021年7月在江苏大学附属医院接受手术。收集并比较两组患者的人口统计学特征、手术参数、实验室检查结果以及临床和影像学结果。
在我们的回顾性研究中，ULIF组在平均总失血量、术中失血量方面优于MI-TLIF组（P＜0.05）。然而，两组间隐性失血量无统计学差异（P＞0.05）。此外，MI-TLIF组的平均手术时间明显长于ULIF组（P＜0.05）。ULIF组术后第1天的平均肌酸激酶（CK）和C反应蛋白（CRP）水平明显较低（P＜0.001）。两组术后所有临床评分均显著改善。ULIF组术后2周和1个月时的腰部疼痛视觉模拟评分（VAS）明显较低（P＜0.05）。术前或术后最终随访时硬膜囊横截面积的变化在两组间无显著差异。术后6个月时ULIF组的融合率明显更高（P＜0.05）。
与MI-TLIF相比，ULIF技术具有出血少、炎症反应轻和融合早的优点。然而，这种方法的手术时间有限。不过，需要进行更长期的随访以观察进一步的临床结果。
