Related Experiment Video
Updated: Jun 16, 2026
Clinical Application of Microscope-Assisted Minimally Invasive Anterior Lumbar Interbody Fusion
Published on: June 16, 2023
Comparative study of two minimally invasive transforaminal interbody fusions for single-segment lumbar disc
Yanhao Ge1,2, Shixiang Wu2, Xuequan Zhao1,2
1Nanjing University of Chinese Medicine, Nanjing, China.
Objective:
In this study, we aimed to evaluate and compare the clinical efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of single-level lumbar disc herniation (LDH).
Methods:
A total of 60 patients who underwent surgery between January 2023 and January 2024 were retrospectively enrolled and divided into two groups based on the surgical technique: UBE-TLIF (n = 34) and MIS-TLIF (n = 26). Efficacy was evaluated using perioperative indicators, follow-up results, and imaging results.
Results:
Following surgery, both groups demonstrated significant longitudinal improvements in visual analog scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores compared with preoperative levels (P < 0.05). However, no statistically significant intergroup differences were observed at 1 week, 3 months, and the final follow-up (P > 0.05). Although the duration of hospital stay was comparable between the two groups, the operative time was significantly longer in the UBE-TLIF group (P < 0.05). Notably, the UBE-TLIF group had significantly lower values for hidden blood loss (HBL), visible blood loss (VBL), and total blood loss (TBL) than the MIS group (P < 0.05). Regarding radiographic parameters, both groups showed significant intragroup improvements in intervertebral space height, Cobb angle, and lumbar lordosis (LL) at 1 month and the final follow-up compared with preoperative levels (P < 0.05). Although the Cobb angle and LL showed statistical differences between the two groups at the final follow-up (P < 0.05), the absolute differences were minimal, indicating that both techniques achieved clinically comparable outcomes in sagittal alignment reconstruction.
Discussion:
Although UBE-TLIF requires a longer operative time than MIS-TLIF, it significantly reduces HBL, VBL, and TBL. Both surgical techniques yield favorable and comparable outcomes in terms of early pain relief, long-term clinical efficacy, and interbody fusion. Therefore, for middle-aged and elderly patients with single-level LDH, although both procedures are highly effective, UBE-TLIF demonstrates specific perioperative advantages in terms of blood conservation.
