Comparison of the safety and efficacy of unilateral biportal endoscopic lumbar interbody fusion and uniportal endoscopic lumbar interbody fusion: a 1-year follow-up

Abstract

Objectives To compare the short-term outcomes of unilateral biportal endoscopic lumbar interbody fusion (BLIF) and uniportal endoscopic lumbar interbody fusion (ULIF). Methods Sixty patients diagnosed with L4/5 spinal stenosis who underwent BLIF and ULIF were included (30 in each group). Clinical evaluation was performed preoperatively and postoperatively in the 1st week, 1st month, and 1st year. Factors such as the visual analogue score (VAS), Oswestry Disability Index (ODI), operative time, surgical complications, and radiological outcomes (fusion rate, screw loosening, and cage subsidence) were compared between the two groups. Results All patients showed improved mean VAS and ODI at all three postoperative follow-ups, and no statistically significant differences were detected between the BLIF and ULIF groups. The mean operative time in the BLIF group was shorter than that in the ULIF group. Nerve root injury occurred in two patients in the BLIF group, while leakage of cerebrospinal fluid occurred in one patient in the ULIF group. All adverse events were treated adequately prior to discharge. The fusion rates with definite and probable grades were significantly higher in the BLIF group than that in the ULIF group. One case of cage subsidence with no screw loosening occurred in each group. Conclusion Both BLIF and ULIF are safe and effective surgical techniques. Compared with ULIF, BLIF has the advantages of shorter operative time and a higher fusion rate. Other merits of BLIF include a wider surgical field, greater maneuverability of instruments, visibility during cage implantation, and transverse orientation of the cage.

Postoperative bone graft migration into the thecal sac and shifting down to the lower level after an endoscopic lumbar interbody fusion: a case report

“…Then, an ELIF was performed using a lordotic polyetheretherketone (PEEK) graft (26 mm length × 10 mm width × 10 mm height) packed with allograft bone. The procedure was in line with the article we published earlier [ 7 ]. The surgery went smoothly in all steps including pedicle screws placement, decompression and cage implantation.…”

Evaluation of the learning curve and complications in unilateral biportal endoscopic transforaminal lumbar interbody fusion: cumulative sum analysis and risk-adjusted cumulative sum analysis

“…The UBE technique allows the establishment of portals through the skin without the limitation of operating a trocar, meanwhile, ULIF can place a larger cage and adjust the cage angle more conveniently, which may be the reason why ULIF has better fusion rate [ 16 ]. Previous studies have shown that ULIF presents the advantages of less trauma, less bleeding, faster postoperative recovery, and favorable fusion rate [ 5 ]. A meta-analysis by Yu et al [ 17 ] indicated that compared to conventional TLIF, ULIF has the advantages in relieving postoperative pain, shortening hospital stay, and enhancing functional recovery.…”

“…Since Heo applied the UBE technique to transforaminal lumbar interbody fusion (TLIF) for the first time and got satisfactory outcomes in 2017 [ 4 ], the indications for UBE have gradually expanded to various degenerative spinal diseases. Studies have demonstrated that ULIF has shown favorable clinical outcomes in the treatment of lumbar degenerative diseases [ 5 ]. However, ULIF remains challenging in its early implementation.…”

Transforaminal Interbody Fusion Using the Unilateral Biportal Endoscopic Technique Compared With Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spine Diseases: Analysis of Clinical and Radiological Outcomes

“…After this, fixation of 4 percutaneous pedicle screws was done under C-arm guidance (Figure 2L and 2M). 13,[15][16][17]…”