Comparison of the efficacy between unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and microendoscopic discectomy (MED)-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of mild single-level lumbar spondylolisthesis.

OBJECTIVE

To evaluate the clinical efficacy of Unilateral Biportal Endoscopic Transforaminal Lumbar Interbody Fusion (UBE-TLIF) versus Microendoscopic Discectomy (MED)-assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) in the treatment of mild single-level lumbar spondylolisthesis (LSS).

METHODS

Clinical data from 120 LSS patients treated with UBE-TLIF (n=66) or MIS-TLIF (n=54) in our hospital’s Department of Spinal Surgery (January 2021–December 2023) were retrospectively analyzed. Intraoperative (operative time, blood loss), postoperative (time to ambulation, hospital stay), and radiographic parameters (lumbar lordosis, Cobb angle), as well as clinical outcomes (Visual Analog Scale [VAS] for back/leg pain, Oswestry Disability Index [ODI]) and Complication rates, were compared between groups.

RESULTS

Compared with the MIS-TLIF group, the UBE-TLIF group exhibited significantly longer operative time but reduced intraoperative blood loss and shorter hospital stays (P<0.001). No significant differences were observed in preoperative or postoperative VAS and ODI scores between groups (P>0.05). Both groups demonstrated significant improvements in lumbar lordosis and Cobb angle at final follow-up (P<0.05), with no intergroup differences in the magnitude of improvement (P>0.05). Fusion rates and complication rates were comparable (P>0.05).

CONCLUSION

Both UBE-TLIF and MED-assisted MIS-TLIF achieved satisfactory short-term outcomes for mild LSS with comparable safety profiles. Despite longer operative duration, UBE-TLIF offers advantages in reduced perioperative bleeding, shorter hospitalization, and faster early recovery without increasing complication risks compared to MIS-TLIF.