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Comparative Study
. 2024 Nov 13;24(1):355.
doi: 10.1186/s12893-024-02651-5.

Comparison of results among UBE-TLIF, MIS-TLIF and open TLIF for Meyerding grade I lumbar spondylolisthesis: a retrospective study

Zhenyuan Lu  1 , Dian Zhong  1 , Yang Liu  1 , Guosheng Zhao  1 , Zhenyong Ke  1 , Yang Wang  2
Affiliations
Comparative Study

Comparison of results among UBE-TLIF, MIS-TLIF and open TLIF for Meyerding grade I lumbar spondylolisthesis: a retrospective study

Zhenyuan Lu et al. BMC Surg. .

Abstract

Background: The unilateral biportal endoscopic (UBE) technique has garnered significant attention for its little paraspinal iatrogenic damage, expedited recovery, and low complication rates. This method is also applicable to open transforaminal lumbar interbody fusion (TLIF). Therefore, this study aimed to conduct a comparative analysis of the outcomes associated with unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), and TLIF for Meyerding grade I lumbar spondylolisthesis.

Methods: The study examined the outcomes of 79 patients with Meyerding grade I lumbar spondylolisthesis who underwent single-level intervertebral fusion. Clinical assessments included the measurement of pain levels using the Visual Analogue Scale (VAS) for low back and leg pain, the Oswestry Disability Index (ODI), surgical data, and demographic information. Imaging techniques were utilized to evaluate the fusion rate.

Results: The VAS-Back demonstrated a statistically significant improvement in Group UBE-TLIF compared to the other groups at the one-week postoperative evaluation (p < .05). Additionally, the UBE-TLIF group exhibited a significantly longer total operative time compared to the other groups (p < .05). However, it was noted that the Postop Hemovac drain were significantly greater in the MIS-TLIF and TLIF groups compared to the UBE-TLIF group (p < .05).

Conclusions: The present research demonstrated the effectiveness of UBE-TLIF, MIS-TLIF, and TLIF as surgical approaches for treating Meyerding grade I lumbar spondylolisthesis. Among these methods, UBE-TLIF demonstrated a reduction in Postop Hemovac drain, and an increase in operative duration.

Keywords: Lumbar spondylolisthesis; Minimally invasive transforaminal lumbar interbody fusion; Transforaminal lumbar interbody fusion; Unilateral biportal endoscopy technology.

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Conflict of interest statement

Declarations Ethics approval and consent to participate The study was approved by the Institutional Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University, and was conducted according to the ethical standards of Helsinki Declaration (1964) and its subsequent amendments. Informed consent was obtained from all subjects and/or their legal guardians. Consent for publication Not applicable. Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
UBE-TLIF surgical procedure: (A) DR in preop; (B) Positioning the pedicle of the vertebral arch; (C) Intraoperative imaging confirmed the position of portal; (D) Cut the lower articular process, and bitted off some upper articular processes; (E) Exposed the nerve root; (F) Exposed the intervertebral disc; (G) Cleaned the intervertebral disc and upper and lower endplates; (H) Compressed the bone graft; (I) Implanted the intervertebral fusion cage; (J) The intraoperative imaging confirmed that the position of the cage was good; K.L. Intraoperative imaging confirmed good internal fixation position
Fig. 2
Fig. 2
Clinical outcomes during follow-up (preoperative, postoperative 1 week, postoperative 1 month, postoperative 6 months, and postoperative 12 months). A, VAS of the back. B, VAS of the leg. C, ODI (%). All clinical parameters improved significantly over the baseline value from 1 week after surgery, which lasted until the final follow-up examination (p < .05). VAS of the back was significantly improved in Group UBE-TLIF compared to other groups at 1 week after surgery. VAS, visual analog scale; ODI, Oswestry Disability Index. **** P < .0001
Fig. 3
Fig. 3
A 62-year-old female patient with L4/5 lumbar spondylolisthesis (Meyerding grade I) in UBE-TLIF group, (A) Preoperative lateral X-ray films; (B) Lateral X-ray films at 3 days after operation showed that the spondylolisthesis had been reduced; (C) CT at 3 months after operation showed that the intervertebral bone graft was sufficient and the position of the Cage was good; (D) Lateral X-ray films at 1 years after operation showed good reduction of vertebral bodies and bony fusion between vertebral bodies
Fig. 4
Fig. 4
A 64-year-old male patient with L4/5 lumbar spondylolisthesis (Meyerding grade I) in MIS-TLIF group. (A) Preoperative lateral X-ray films; (B) Lateral X-ray films at 3 days after operation showed that the spondylolisthesis had been reduced; (C) CT at 3 months after operation showed that the intervertebral bone graft was sufficient and the position of the Cage was good; (D) Lateral X-ray films at 1 years after operation showed good reduction of vertebral bodies and bony fusion between vertebral bodies
Fig. 5
Fig. 5
A 30-year-old male patient with L5/S1 lumbar spondylolisthesis (Meyerding grade I) in TLIF group. (A) Preoperative lateral X-ray films; (B) Lateral X-ray films at 3 days after operation showed that the spondylolisthesis had been reduced; (C) CT at 3 months after operation showed that the intervertebral bone graft was sufficient and the position of the Cage was good; (D) Lateral X-ray films at 1 years after operation showed good reduction of vertebral bodies and bony fusion between vertebral bodies
Fig. 6
Fig. 6
Intra-group comparisons of Operative data. (A) The operative time. (B) Hospital day (C) Postop Hemovac drain. **** P < .0001, ** P < .01
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