Comparison Of Short-term Efficacy Between Unilateral Biportal Endoscopic Lumbar Interbody Fusion And Open Transforaminal Lumbar Interbody Fusion In The Treatment Of Lumbar Spinal Stenosis

OBJECTIVE:To observe the short-term efficacy and safety of unilateral biportal endoscopic lumbar interbody fusion(ULIF)and open transforaminal lumbar interbody fusion(TLIF)in the treatment of single segment lumbar spinal stenosis.METHODS:The clinical and follow-up data of 40 patients with single segment lumbar spinal stenosis admitted to our hospital from January 2021 to January 2022 were retrospectively analyzed,and they were grouped according to different surgical methods.There were 20 cases in UBE group,and 20 cases in TLIF group,Collect and compare the operation duration,intraoperative blood loss,postoperative drainage volume,and postoperative hospitalization days of the two groups of patients.All patients were evaluated for VAS scores,ODI dysfunction index scores,and JOA scores for low back pain at different stages before and after surgery.At the last follow-up,the clinical efficacy was evaluated using the Mac Nab standard.The SUK standard was used to evaluate the intervertebral fusion.Record and analyze the above data.RESULTS:The gender of patients in the ULIF group was(male: female=12:8),age was(59.45 ± 5.87)years old,duration of disease was(24.40 ± 8.34)months,surgical segments were L4-5 and L5S1(19,1),and follow-up time was(13.85 ± 1.14)months;The gender of patients in the TLIF group was(male:female=11:9),age was(61.60 ± 4.57)years old,duration of disease was(26.65 ± 7.82)months,surgical segments were L4-5 and L5S1(18,2),and follow-up time was(13.50 ± 1.10)months.There was no statistically significant difference in general basic data between the two groups of patients(P>0.05).Both groups of patients successfully completed the surgery.Compared with patients in TLIF group,patients in ULIF group had a higher operation duration(161.50 ± 16.31 min vs 142.00 ± 18.88 min,P<0.05),but patients in ULIF group had less intraoperative blood loss(185.50 ± 38.18 ml vs 255.50 ± 28.92 ml,P<0.05),less postoperative drainage volume(102.00 ± 20.99 ml vs 143.75 ± 21.02 ml,P<0.05),and shorter postoperative hospitalization days(6.60 ± 1.70 d vs 8.85 ± 2.19 d,P<0.05).The postoperative VAS score,ODI score,and JOA score of patients in both groups were significantly lower than those before surgery(P<0.05).The VAS scores of patients in ULIF group at 1 week and 1 month after surgery were not statistically significant compared with those in TLIF group(P>0.05),but the ODI scores and JOA scores of patients in ULIF group at 1 month and 3 months after surgery were lower than those in TLIF group(P<0.05).No nerve root injury occurred in either group,but there was one patient with dural tear in ULIF group and one patient with incision effusion in TLIF group.There was no statistically significant difference in the complications between the two groups(P>0.05).At the last follow-up,the Mac Nab standard excellent and good rate was 95% in ULIF group and 90% in TLIF group,with no statistically significant difference between the two groups(P>0.05).There was no significant difference in the rate of intervertebral fusion between the two groups at the last follow-up(P >0.05).CONCLUSION:1.The efficacy of ULIF in treating single segment lumbar spinal stenosis is similar and safe to that of TLIF.2.ULIF has the advantages of less intraoperative blood loss,shorter postoperative hospitalization days,less early postoperative low back pain,and rapid functional recovery,which is worth promoting in clinical practice.