Comparison of LBP, LP, ODI of the two groups.

Background
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).
Methods
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.
Results
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).
Conclusion
UBE-LIF can achieve better perioperative clinical outcomes than Mis-TLIF. However, in the long-term, these two procedures can achieve equivalent clinical efficacy.

背景
微创经椎间孔腰椎体间融合术（Minimally invasive transforaminal lumbar interbody fusion, MIS-TLIF）是目前临床最常用的腰椎融合术式之一。近年来，单侧双通道内镜下腰椎体间融合术（Unilateral biportal endoscopic lumbar interbody fusion, UBE-LIF）也逐渐受到脊柱外科医师的关注。本研究旨在对比两种术式治疗腰椎退行性疾病（Lumbar degenerative diseases, LDD）的围手术期及长期临床结局。

方法
我们收集了2019年1月至2022年12月期间，因腰椎退行性疾病接受微创经椎间孔腰椎体间融合术（MIS-TLIF）或单侧双通道内镜下腰椎体间融合术（UBE-LIF）治疗的患者临床数据。主要结局指标为术后12个月的Oswestry功能障碍指数（Oswestry Disability Index, ODI）。次要结局指标包括术后12个月的腰背痛（Low back pain, LBP）与下肢痛（Leg pain, LP）视觉模拟评分（Visual Analog Scale, VAS），以及术后并发症发生率。

结果
两组患者术前的腰背痛VAS评分、下肢痛VAS评分及ODI评分均无显著差异。术后1周时，UBE-LIF组患者的腰背痛VAS评分显著低于MIS-TLIF组（1.4±1.1 vs. 2.1±1.0，P=0.001）。但在术后1、6及12个月时，两组的腰背痛VAS评分、下肢痛VAS评分及ODI评分均无显著差异。UBE-LIF组的住院时长显著短于MIS-TLIF组（5.2±1.1 vs. 6.3±1.2天，P<0.001）。UBE-LIF组的手术时长显著长于MIS-TLIF组（188.9±19.8 vs. 159.5±11.6分钟，P<0.001），但术中估计失血量（131.0±21.9 vs. 191.7±23.3ml，P<0.001）及术后引流液量（123.0±55.4 vs. 191.2±47.5ml，P<0.001）均显著低于MIS-TLIF组。UBE-LIF组的并发症发生率略高于MIS-TLIF组，但差异无统计学意义（11.5% vs. 5.0%，P=0.299）。

结论
UBE-LIF在围手术期临床结局方面优于MIS-TLIF，但从长期随访来看，两种术式的临床疗效相当。