Objective  To compare the effectiveness of uniportal endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF), and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of single-level lumbar degenerative disease. Methods  A retrospective analysis was conducted on 130 patients with single-level lumbar degenerative disease treated between January 2019 and December 2022. According to the surgical technique, patients were divided into the MIS-TLIF group (43 cases), the Endo-TLIF group (45 cases), and the UBE-TLIF group (42 cases). Baseline data, including age, gender, operated level, disease type, preoperative lower-extremity pain visual analogue scale (VAS) score, and Oswestry disability index (ODI), showed no significant difference among the three groups (P>0.05). Operation time, estimated intraoperative blood loss, postoperative hospital stays, and perioperative complications were recorded. Clinical symptoms were evaluated preoperatively and at 1 day, 1 month, 3 months, 1 year, and 2 years postoperatively using the lower-extremity pain VAS score and ODI. Interbody fusion was evaluated using the Suk method at 2 years postoperatively. Surgical outcomes and quality of life were assessed using the modified MacNab criteria and EuroQol-5 Dimensions (EQ-5D) at last follow-up. Results  There was no significant difference in operation time among the three groups (P>0.05). The estimated intraoperative blood loss in MIS-TLIF group was the most, while that in Endo-TLIF group was the least, and there were significant differences among the three groups (P<0.05). The postoperative hospital stay was significantly shorter in the Endo-TLIF group and the UBE-TLIF group than in the MIS-TLIF group (P<0.05), while no significant difference was observed between the Endo-TLIF and UBE-TLIF groups (P>0.05). No serious complications, such as severe neurological injury or intervertebral space infection, occurred intraoperatively in any of the three groups. In the MIS-TLIF, Endo-TLIF, and UBE-TLIF groups, some patients experienced transient neurological dysfunction, minor dural tears, or delayed wound healing, respectively; however, there was no significant difference in the overall complication incidence among the three groups (9.30% vs 6.67% vs 7.14%, P>0.05). All patients in the three groups were followed up 24-36 months, with an average of 26.62 months. At all postoperative follow-up time points, both lower-extremity pain VAS scores and ODI in three groups significantly improved compared to the preoperative values (P<0.05). In intergroup comparisons, except that the VAS score at 1 day postoperatively in the Endo-TLIF group was significantly lower than that in the MIS-TLIF group (P<0.05), no significant difference was found in VAS scores or ODI among the three groups at the same follow-up time points (P>0.05). At 2 years postoperatively, the solid interbody fusion rate exceeded 92% in all three groups, and the excellent-to-good rate assessed by the modified MacNab criteria at last follow-up was greater than 90%. No significant difference was observed among the three groups in terms of interbody fusion status, surgical outcome grade, or EQ-5D score (P>0.05). Conclusion  Endo-TLIF and UBE-TLIF achieve effectiveness and fusion rates comparable to those of MIS-TLIF for single-level lumbar degenerative disease, with advantages of less trauma, reduced blood loss, and faster recovery.

Citation： LI Yiming, KONG Weiqing, LI Jie, MA Chao, REN Yongxin. Comparison of effectiveness between two endoscopic lumbar interbody fusion techniques and minimally invasive transforaminal lumbar interbody fusion for single-level lumbar degenerative disease. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(3): 438-446. doi: 10.7507/1002-1892.202512031 Copy

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