Retrospective Analysis Of Early Clinical Efficacy Of Unilateral Biportal Endoscopic Lumbar Interbody Fusion And Uniportal Endoscopic Lumbar Interbody Fusion For Single Level Ⅰ And Ⅱ Degree Lumbar Spondylolisthesis

Objective:To compare the short-term outcomes of unilateral biportal endoscopic lumbar interbody fusion(BLIF)and uniportal endoscopic lumbar interbody fusion(ULIF)in the treatment of degree Ⅰ or degree Ⅱ single-segment lumbar spondylolisthesis.Methods: 1.A total of 59 patients with single-level Ⅰ and Ⅱ lumbar spondylolisthesis who underwent surgical treatment in the First Department of Neck,shoulder,low back and Leg Pain of Sichuan Orthopedic Hospital from December 2020 to December 2021 were retrospectively analyzed.According to the different surgical methods,they were divided into BILF(unilateral biportal endoscopic lumbar interbody fusion)group and ULIF(unilateral endoscopic lumbar interbody fusion)group.The ULIF group underwent endoscopic lumbar interbody fusion under coaxial large channel,a total of 29 cases.2.Collect surgery-related indicators,including operation time,postoperative hospitalization days,postoperative complications,etc.Preoperative VAS score and ODI index of back and leg pain were recorded.VAS score and ODI index of back and leg pain were collected at each time point 1 week,1 month,6 months and 1year after surgery to evaluate the surgical effect.lumbar vertebra angle(LL)and slip angle(SA)of the two groups were measured by lateral lumbar radiographs before and after operation,and lumbar CT examination was performed 12 months after operation and intervertebral fusion was evaluated based on Bridwell bone fusion evaluation criteria.All data were analyzed using SPSS 27.0.Results: All patients were followed up for more than 1 year.General data such as age,gender,slippage segment,degree of slippage,preoperative VAS score of back and leg pain,preoperative ODI index were compared between the two groups,and the results showed that P > 0.05 was comparable.The VAS score of low back pain,VAS score of leg pain,and ODI index of the two groups at 1 year after operation were significantly lower than those before operation,P < 0.05,but there was no significant difference between the two groups at each time point after operation(P > 0.05).Imaging evaluation indexes: Compared with preoperative results,lumbar lordosis Angle and spondylolisthesis Angle were significantly increased in both groups 1 year after surgery(P < 0.05).At 12 months after surgery,according to the evaluation criteria based on Bridwell bone graft fusion,both groups achieved successful fusion,including 27 cases of Grade Ⅰ fusion in the BLIF group,3 cases of grade Ⅱ fusion,25 cases of grade Ⅰ fusion in the ULIF group,4cases of grade Ⅱ fusion,there was no statistical significance between the two groups(P > 0.05).Conclusion: The early curative effect of unilateral double channel and coaxial large channel endoscopic lumbar interbody fusion in the treatment of single level I and II degree lumbar spondylolisthesis is significant.BLIF and ULIF are both effective and safe,and both techniques can be effective in relieving pain and improving lumbar function.BLIF has the advantages of shorter operating time compared to ULIF.