Abstract:This report describes a novel endoscopic fusion technique performed with unilateral biportal endoscopy (UBE) that is known as extreme transforaminal lumbar interbody fusion (eXTLIF) and is performed with a large spacer. We also present the short-term results of this procedure. Previous studies reported that minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) could achieve acceptable rates of fusion; therefore, it is often used for treating various degenerative lumbar diseases. Moreover, MIS-TL… Show more
“…To ensure the integrity of the data, a screening of included studies in recent UBE reviews 30-33 and identified 4 additional studies that were subsequently incorporated into this research. 34-37 The specific search process is shown in Figure 1.Figure 1.Flow diagram of study selection.…”
Section: Resultsmentioning
confidence: 99%
“…However, to properly install the giant OLIF cage in the Ex-TLIF approach, not only a higher inclined angle is required, but also an additional paravertebral portal is made for the insertion of a large OLIF cage. 24 , 36 …”
Section: Resultsmentioning
confidence: 99%
“…However, to properly install the giant OLIF cage in the Ex-TLIF approach, not only a higher inclined angle is required, but also an additional paravertebral portal is made for the insertion of a large OLIF cage. 24,36 In comparison to the UBE-EFLIF approach, the EX-TLIF approach has implemented 2 noteworthy enhancements. Initially, the auxiliary portal is relocated to the outer margin of the pedicle.…”
Study Design Review. Objective Unilateral Biportal Endoscopy (UBE) is a minimally invasive surgery that is gaining recognition and being employed in clinical practice. Nevertheless, the precise method for determining UBE portals’ location varies depending on the originator’s preferences or the anatomical structure’s proximity to the portal positions. Consequently, the relationship among UBE portals' locations is messy. This study aims to elaborate on the specific portal localization and explore the positional association and commonality among different UBE approaches’ portals. Methods The following keywords are used to search in the PubMed, Ovid, Web of Science, ScienceDirect, SpringerLink, Scopus, CNKI, and Wanfang database: “Biportal endoscopic spinal surgery”, “Two portal endoscopic spinal surgery”, “Percutaneous biportal endoscopic decompression”, “Unilateral biportal endoscopy”, “Irrigation endoscopic discectomy”, “UBE” and “BESS”. Results After screening, 29 pieces of literature are included. The study summarizes different UBE approach portal localizations, categorized by fusion or non-fusion surgery and pathological classification. The study presents an inaugural method for categorizing the lumber into four surgical intervals based on bone landmarks and assigns different UBE approaches to the appropriate intervals based on their characteristics, making the selection of UBE surgical approaches’ portal locations more flexible. Additionally, the study provides an overview of the indications, complications, and distinct benefits associated with each interval, further refining the novel UBE portal interval localization method. Conclusion The study clarifies the interrelationship and commonality between the portals of different UBE approaches and proposes a new UBE portal interval localization method to enhance surgeons’ understanding and proficiency in UBE procedures.
“…To ensure the integrity of the data, a screening of included studies in recent UBE reviews 30-33 and identified 4 additional studies that were subsequently incorporated into this research. 34-37 The specific search process is shown in Figure 1.Figure 1.Flow diagram of study selection.…”
Section: Resultsmentioning
confidence: 99%
“…However, to properly install the giant OLIF cage in the Ex-TLIF approach, not only a higher inclined angle is required, but also an additional paravertebral portal is made for the insertion of a large OLIF cage. 24 , 36 …”
Section: Resultsmentioning
confidence: 99%
“…However, to properly install the giant OLIF cage in the Ex-TLIF approach, not only a higher inclined angle is required, but also an additional paravertebral portal is made for the insertion of a large OLIF cage. 24,36 In comparison to the UBE-EFLIF approach, the EX-TLIF approach has implemented 2 noteworthy enhancements. Initially, the auxiliary portal is relocated to the outer margin of the pedicle.…”
Study Design Review. Objective Unilateral Biportal Endoscopy (UBE) is a minimally invasive surgery that is gaining recognition and being employed in clinical practice. Nevertheless, the precise method for determining UBE portals’ location varies depending on the originator’s preferences or the anatomical structure’s proximity to the portal positions. Consequently, the relationship among UBE portals' locations is messy. This study aims to elaborate on the specific portal localization and explore the positional association and commonality among different UBE approaches’ portals. Methods The following keywords are used to search in the PubMed, Ovid, Web of Science, ScienceDirect, SpringerLink, Scopus, CNKI, and Wanfang database: “Biportal endoscopic spinal surgery”, “Two portal endoscopic spinal surgery”, “Percutaneous biportal endoscopic decompression”, “Unilateral biportal endoscopy”, “Irrigation endoscopic discectomy”, “UBE” and “BESS”. Results After screening, 29 pieces of literature are included. The study summarizes different UBE approach portal localizations, categorized by fusion or non-fusion surgery and pathological classification. The study presents an inaugural method for categorizing the lumber into four surgical intervals based on bone landmarks and assigns different UBE approaches to the appropriate intervals based on their characteristics, making the selection of UBE surgical approaches’ portal locations more flexible. Additionally, the study provides an overview of the indications, complications, and distinct benefits associated with each interval, further refining the novel UBE portal interval localization method. Conclusion The study clarifies the interrelationship and commonality between the portals of different UBE approaches and proposes a new UBE portal interval localization method to enhance surgeons’ understanding and proficiency in UBE procedures.
“…In this study, the short-term radiological results of the two groups were analyzed, OLIF-AF group was superior to the ULIF group in terms of DH recovery, and the rate of improvement in the LL and Segmental angle was better in the OLIF-AF group compared to ULIF group, which may be related to the use of a larger size cage in OLIF-AF group. Eum et al [ 24 ] conducted a retrospective study on 22 patients, all patients underwent extreme transforaminal lumbar interbody fusion (eXTLIF) in unilateral biportal endoscopy (UBE) and used a large profile fusion cage. The follow-up time was more than 6 months, and satisfactory results were obtained.…”
Background
Oblique lumbar interbody fusion (OLIF) has been proven to be an effective method of indirect decompression for the treatment of Degenerative Lumbar Spondylolisthesis (DLS). However, its superiority over Unilateral biportal endoscopic Lumbar Interbody Fusion (ULIF) has not been reported yet. The current study aimed to compare the clinical and radiological outcomes of OLIF and ULIF in patients with DLS.
Methods
A total of 107 patients were included in this study, divided into two groups according to the surgical methods with 45 patients treated by OLIF combined with anterolateral single screwrod fixation, and 62 patients treated by ULIF. To compare the perioperative parameters (blood loss, operation time, and postop hospitalization) and clinical (the Visual Analog Scale (VAS) scores of the low back pain and leg pain and the Oswestry Disability Index (ODI)) and radiological (disk height (DH), lumbar lordosis (LL), segmental lordosis (SL), the cross-sectional area (CSA) of the spinal canal) results of the two surgical approaches to evaluate their efficacy.
Results
Compared with the ULIF group, the blood loss and operation time in the OLIF-AF group were significantly reduced, and the Postop hospitalization was comparable. The VAS scores in both groups were significantly improved compared to preop; however, the VAS score of low back pain in the OLIF-AF group was superior to that in ULIF group throughout the follow-up period (P < 0.05). The improvements in DH, LL, and Segmental angle were significantly lower in the ULIF group, and the expansion rate of CSA in the OLIF-AF group was superior to that in the ULIF group, but the difference was not statistically significant. The fusion rate in OLIF-AF group was significantly higher than that in ULIF group within 6 mo postop, and there was no significant difference at the last follow-up. The incidence of complications was comparable between the two groups, and there was no statistical difference.
Conclusions
Both OLIF-AF and ULIF achieved good short-term results in the treatment of DLS, and both surgical approaches are desirable. However, OLIF-AF has advantages over ULIF in terms of postoperative restoration of lumbar sagittal parameters and earlier intervertebral fusion. Long-term follow-up and larger clinical studies are needed to confirm this result.
“…Successful intervertebral fusion depends on thorough intervertebral disc removal and endplate preparation with a greater contact area. [ 36 ] In comparison to traditional methods, ULIF enables the surgeon to view the interbody incision and vertebral endplate using magnified endoscopy. This helps the surgeon avoid excessive or insufficient scraping of the bearing bone surface and lowers the risk of postoperative fusion descent or displacement.…”
Background:
To evaluate the clinical efficacy and prognosis of unilateral biportal endoscopic lumbar fusion (ULIF) and minimally invasive transforaminal lumbar fusion (MIS-TLIF) for lumbar degenerative diseases.
Methods:
Chinese and English databases were retrieved for the period from database creation to December 31, 2022. Case-control studies on unilateral biportal endoscopic lumbar fusion were collected. The observation indexes consisted of operation times, intraoperative blood loss, postoperative drainage volume, length of hospital stay, postoperative pain score, postoperative oswestry disability index score, postoperative MacNab excellent and good rate, imaging fusion rate at the last follow-up, and complications. The NO rating table was employed to assess the quality of the included literature, and a meta-analysis was conducted using Revman5.4.1 and Stata17.
Results:
Ten studies with 738 surgical patients were considered, including 347 patients in the ULIF group and 391 in the MIS-TLIF group. This Meta-analysis demonstrated statistically significant differences in mean operation duration, intraoperative blood loss, postoperative drainage volume, length of hospital stay, and early postoperative (1–2W) visual analogue scale/score (VAS) scores for back pain. No significant differences were observed in the final follow-up postoperative VAS scores for back pain, postoperative leg VAS score, postoperative oswestry disability index score, excellent and good rate of postoperative modified MacNab, imaging fusion rate, and complications.
Conclusion:
Compared with the MIS-TLIF group, the ULIF group had longer operation time, lower intraoperative blood loss and postoperative drainage volume, lower lumbar VAS score in the early postoperative period, and shorter hospital stay. ULIF is less invasive than traditional MIS-TLIF, making it a trustworthy surgical option for lumbar degenerative diseases with comparable fusion efficiency, superior MacNab rate, and complication rate.
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