Comparison of Outcomes Between Endoscopic Transforaminal Lumbar Interbody Fusion and Minimally Invasive Transforaminal Lumbar Interbody Fusion in Patients With Single-Level Lumbar Degenerative Disease: A Retrospective Study

Abstract

ObjectiveTo compare the clinical and radiological outcomes of endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). MethodsThis retrospective study included 110 patients with single-level lumbar degenerative disease who underwent Endo-TLIF or MIS-TLIF between January 2019 and December 2021. Patients were divided into Endo-TLIF (n = 55) and MIS-TLIF groups (n = 55). Perioperative, clinical, and radiological outcomes were assessed. ResultsThe Endo-TLIF group had significantly lower blood loss and shorter hospital stay. However, the operation time was significantly longer and there was more X-ray exposure than in the MIS-TLIF group. There were no significant differences in complications between the groups. The Endo-TLIF group showed significantly lower creatine kinase (CK) levels than the MIS-TLIF group at 3 days postoperatively (p<0.05), but not at 7 days postoperatively (p>0.05). Oswestry Disability Index (ODI) and visual analog scale (VAS) scores were significantly reduced in both groups at different time points post-operation compared to pre-operation. The VAS score in the Endo-TLIF group was lower than that in the MIS-TLIF group at 3 days postoperatively. Moreover, no significant differences were found in fusion rates, lumbar lordosis (LL), and lumbar segmental lordosis (SL) between the two groups (p>0.05). ConclusionsEndo-TLIF might be considered as an effective and reliable treatment option for single-level lumbar degeneration. It results in less trauma and faster postoperative recovery, but a longer operative time and more X-ray exposure than MIS-TLIF. Endo-TLIF has effects on clinical and radiological outcomes that are comparable to those of MIS-TLIF.