Comparative Analysis of Clinical and Radiological Outcomes of Unilateral Biportal Endoscopic Transforaminal Lumbar...

Objectives The main objective of this study is to compare clinical and radiological outcomes of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) with dual-direction expandable cages, versus anterior lumbar interbody fusion (ALIF) at L5/S1. Summary of literature review Traditional ALIF and TLIF approaches have limitations. UBE-TLIF with dual-direction expandable cages represents an emerging, minimally invasive alternative with potential advantages in tissue preservation and anatomical restoration. Materials and methods Six patients underwent UBE-TLIF at L5/S1 using expandable titanium cages. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). Radiological parameters included disc height and neural foraminal height. Results were compared with ALIF outcomes from 11 literature studies. Results VAS decreased from 7.7 ± 1 to 4 ± 2 (back pain) and 8.2 ± 0.9 to 3 ± 2.1 (leg pain). ODI improved from 59 ± 5.8 to 27.5 ± 15. Disc height increased from 5.6 ± 1.5 mm to 15.8 ± 0.6 mm, and foraminal height from 8.8 ± 4 mm to 16.8 ± 3.4 mm (p < 0.05). Mean operative time was 269.5 minutes, with blood loss of 152 ± 30 mL. Conclusions UBE-TLIF demonstrates outcomes comparable to ALIF, with the advantages of single-position surgery and minimal tissue disruption, representing a viable, minimally invasive alternative for L5/S1 degenerative pathology.