Comparative efficacy and fusion outcomes of unilateral bi-portal endoscopic transforaminal lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion in treating single-segment degenerative lumbar spondylolisthesis with lumbar spinal stenosis: a two-year retrospective study

单侧双通道内镜经椎间孔腰椎椎体间融合术与微创经椎间孔腰椎椎体间融合术治疗单节段退行性腰椎滑脱合并腰椎管狭窄症的疗效及融合结果比较:一项为期两年的回顾性研究

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Abstract

BACKGROUND: Degenerative lumbar spondylolisthesis (DLS) with lumbar spinal stenosis (LSS) is a common condition resulting in substantial lower back pain and disability. Surgical intervention is recommended only when conservative treatment fails. This study compared UBE-TLIF and MIS-TLIF regarding clinical outcomes and fusion rates in patients with single-segment DLS with LSS. METHODS: A total of 85 patients who underwent either UBE-TLIF (n = 40) or MIS-TLIF (n = 45) were examined retrospectively. Clinical results were evaluated by the Visual Analog Scale (VAS) for pain and the Oswestry Disability Index (ODI) for functional outcomes. Radiographs and CT were utilized to assess radiological outcomes such as disc height (DH), lumbar lordosis (LL), and interbody fusion rates. The two groups were also compared in terms of perioperative data (operation time, blood loss, hospital stay, and fluoroscopy exposure). RESULTS: Both surgical techniques showed similar statistically significant improvements in VAS and ODI scores. Fusion rates at 2 years postoperatively were identical, including 95% for the UBE-TLIF group and 97.7% for the MIS-TLIF group. However, compared with MIS-TLIF, the operative time and fluoroscopy exposure were longer for UBE-TLIF, but intraoperative blood loss and length of hospital stay were reduced. CONCLUSIONS: UBE-TLIF and MIS-TLIF can successfully treat single-segment DLS in the presence of LSS, achieving similar clinical and radiological outcomes with low complication rates. Although UBE-TLIF has certain advantages regarding perioperative outcomes (less blood loss and shorter hospital stay), MIS-TLIF is associated with shorter operative times and lower fluoroscopy exposure.

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