Chen Xiang, Xie Jingbo, Zhang Zhihui, Liu Yi, Shi Liang, Hu Lang
Department of Spinal Orthopaedics, Fengcheng People's Hospital, Fengcheng City, Jiangxi Province, China.
Department of Orthopedics, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang City, Hubei Province, China.
PLoS One. 2025 Sep 26;20(9):e0333165. doi: 10.1371/journal.pone.0333165. eCollection 2025.
Minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) is one of the most commonly used methods for lumbar fusion. However, in recent years, the unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) has also gradually attracted the attention of spine surgeons. This study aims to compare the perioperative and long-term clinical outcomes of the two procedures for lumbar degenerative diseases (LDD).
We collected clinical data of patients who had undergone minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) or unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) for lumbar degenerative diseases (LDD) from January 2019 to December 2022. The primary outcome measure was the Oswestry Disability Index (ODI) at 12 months postoperatively. Secondary outcome measures included 12-month visual analog scale (VAS) scores for low back pain (LBP) and leg pain (LP), and postoperative complication rate.
There were no significant differences in the preoperative VAS scores for LBP, LP, or ODI between the two groups. The VAS score for LBP was significantly lower in the UBE-LIF group than in the Mis-TLIF group 1 week postoperatively (1.4 ± 1.1 vs. 2.1 ± 1.0, P = 0.001). However, there was no significant difference in the VAS scores for LBP, LP, and ODI at 1, 6, and 12 months postoperatively. The length of stay was significantly lower in the UBE-LIF than in the Mis-TLIF group (5.2 ± 1.1 vs. 6.3 ± 1.2 days, P < 0.001). The operative time (188.9 ± 19.8 vs. 159.5 ± 11.6 minutes, P < 0.001) of the UBE-LIF group was significantly higher than that of the Mis-TLIF group, while the estimated blood loss (131.0 ± 21.9 vs. 191.7 ± 23.3 ml, P < 0.001) and postoperative drainage volume (123.0 ± 55.4 vs. 191.2 ± 47.5 ml, P < 0.001) were significantly lower in the UBE-LIF than in the Mis-TLIF group. The complication rate was slightly higher in the UBE-LIF than in the Mis-TLIF group; however, the difference was not significant (11.5% vs. 5.0%, P = 0.299).
UBE-LIF can achieve better perioperative clinical outcomes than Mis-TLIF. However, in the long-term, these two procedures can achieve equivalent clinical efficacy.
微创经椎间孔腰椎椎间融合术（Mis-TLIF）是最常用的腰椎融合方法之一。然而，近年来，单侧双通道内镜下腰椎椎间融合术（UBE-LIF）也逐渐引起脊柱外科医生的关注。本研究旨在比较这两种手术治疗腰椎退行性疾病（LDD）的围手术期和长期临床疗效。
我们收集了2019年1月至2022年12月因腰椎退行性疾病（LDD）接受微创经椎间孔腰椎椎间融合术（Mis-TLIF）或单侧双通道内镜下腰椎椎间融合术（UBE-LIF）的患者的临床资料。主要观察指标是术后12个月的Oswestry功能障碍指数（ODI）。次要观察指标包括术后12个月的下腰痛（LBP）和腿痛（LP）视觉模拟量表（VAS）评分以及术后并发症发生率。
两组术前LBP、LP的VAS评分或ODI无显著差异。UBE-LIF组术后1周的LBP VAS评分显著低于Mis-TLIF组（1.4±1.1 vs. 2.1±1.0，P = 0.001）。然而，术后1、6和12个月时，LBP、LP的VAS评分和ODI无显著差异。UBE-LIF组的住院时间显著低于Mis-TLIF组（5.2±1.1 vs. 6.3±1.2天，P < 0.001）。UBE-LIF组的手术时间（188.9±19.8 vs. 159.5±11.6分钟，P < 0.001）显著高于Mis-TLIF组，而UBE-LIF组的估计失血量（131.0±21.9 vs. 191.7±23.3 ml，P < 0.001）和术后引流量（123.0±55.4 vs. 191.2±47.5 ml，P < 0.001）显著低于Mis-TLIF组。UBE-LIF组的并发症发生率略高于Mis-TLIF组；然而，差异不显著（11.5% vs. 5.0%，P = 0.299）。
UBE-LIF在围手术期可取得比Mis-TLIF更好的临床疗效。然而，从长期来看，这两种手术可取得相当的临床疗效。
