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Purpose <p>To compare clinical outcomes and safety of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), unilateral biportal endoscopic lumbar interbody fusion (ULIF), and modified MIS-TLIF via unilateral biportal endoscopic assistance (UBE-MIS-TLIF) for single-segment Schizas C/D LSS.</p> Methods <p>A retrospective analysis of 205 patients (UBE-MIS-TLIF: 37, MIS-TLIF: 93, ULIF: 75) evaluated clinical outcomes using visual analogue scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores, modified MacNab criteria, fusion rates, and complications over 12 months. Surgical parameters and deep ligamentum flavum (LF) preservation were also analyzed.</p> Results <p>All groups demonstrated significant postoperative improvements in VAS [low back pain (LBP)/leg pain], ODI, and JOA scores. MIS-TLIF demonstrated higher VAS scores for incision pain compared to the other two groups. UBE-MIS-TLIF and ULIF exhibited lower LBP VAS and ODI within one week postoperatively. At final follow-up, no significant differences were observed in VAS, ODI, JOA, modified MacNab criteria, complications, intervertebral height index, or fusion rates among these groups. UBE-MIS-TLIF demonstrated significant improvements in intraoperative blood loss, wound drainage volume, CRP level, and postoperative hospital stay compared to MIS-TLIF, while showing no statistically significant differences from ULIF. However, UBE-MIS-TLIF required longer operative time and more fluoroscopy than MIS-TLIF. UBE-MIS-TLIF showed superior performance in preserving the deep LF.</p> Conclusion <p>UBE-MIS-TLIF, MIS-TLIF, and ULIF demonstrated comparable long-term efficacy for single-segment Schizas C/D LSS. As a modified approach, UBE-MIS-TLIF reduced invasiveness versus MIS-TLIF, achieved shorter operative time compared to ULIF, and could preserve the deep LF, offering a viable alternative for severe LSS management.</p>

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Description and assessment of deep ligamentum flavum-preserved modified minimally invasive transforaminal lumbar interbody fusion via unilateral biportal endoscopic assistance: a one-year retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年4月6日

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  • Ziwei Fan,
  • Guoliang Chen,
  • Yaozhi He,
  • Chaohui Ding,
  • Dingjun Xu,
  • Yiwei Teng,
  • Qiumin Deng,
  • Jing Wang,
  • Minyu Zhu,
  • Honglin Teng

摘要

Purpose

To compare clinical outcomes and safety of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), unilateral biportal endoscopic lumbar interbody fusion (ULIF), and modified MIS-TLIF via unilateral biportal endoscopic assistance (UBE-MIS-TLIF) for single-segment Schizas C/D LSS.

Methods

A retrospective analysis of 205 patients (UBE-MIS-TLIF: 37, MIS-TLIF: 93, ULIF: 75) evaluated clinical outcomes using visual analogue scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores, modified MacNab criteria, fusion rates, and complications over 12 months. Surgical parameters and deep ligamentum flavum (LF) preservation were also analyzed.

Results

All groups demonstrated significant postoperative improvements in VAS [low back pain (LBP)/leg pain], ODI, and JOA scores. MIS-TLIF demonstrated higher VAS scores for incision pain compared to the other two groups. UBE-MIS-TLIF and ULIF exhibited lower LBP VAS and ODI within one week postoperatively. At final follow-up, no significant differences were observed in VAS, ODI, JOA, modified MacNab criteria, complications, intervertebral height index, or fusion rates among these groups. UBE-MIS-TLIF demonstrated significant improvements in intraoperative blood loss, wound drainage volume, CRP level, and postoperative hospital stay compared to MIS-TLIF, while showing no statistically significant differences from ULIF. However, UBE-MIS-TLIF required longer operative time and more fluoroscopy than MIS-TLIF. UBE-MIS-TLIF showed superior performance in preserving the deep LF.

Conclusion

UBE-MIS-TLIF, MIS-TLIF, and ULIF demonstrated comparable long-term efficacy for single-segment Schizas C/D LSS. As a modified approach, UBE-MIS-TLIF reduced invasiveness versus MIS-TLIF, achieved shorter operative time compared to ULIF, and could preserve the deep LF, offering a viable alternative for severe LSS management.