Our experience with the use of unilateral biportal endoscopic lumbar interbody fusion (UBLIF) and posterior lumbar interbody fusion (PLIF) in the treatment of patients with spinal stenosis of the lumbar spine

Abstract

In addition to endoscopic discectomy, patients with stenosis of the spinal canal of the lumbar spine quite often undergo endoscopic decompression and / or stabilization. Spinal endoscopic surgery has several advantages compared to open operations, however, the lack of differences in long-term clinical results, a small workspace with a limited field of view and a large learning curve compared to conventional operations are disadvantages of endoscopic spinal surgery. The aim of the study was to compare the clinical and radiological results of unilateral biportal endoscopic lumbar interbody fusion (UBLIF) versus conventional posterior lumbar interbody fusion (PLIF) using data from a one-year follow-up period. Material and methods. 25 patients underwent surgery using the UBLIF method (age 68 ± 8 years) and 31 patients underwent surgery using the PLIF method (66 ± 9 years) at one lumbosacral level (observation period – 1 year). Perioperative data, clinical results (the level of pain in the back and legs according to VAS (cm), and the level of disability – using the Oswestry Disability Index (ODI, %)) were evaluated. Results. In our study, we analyzed the effectiveness of two methods: unilateral biportal endoscopic lumbar interbody fusion (UBLIF) and traditional posterior lumbar interbody fusion (PLIF). Assessment of back pain: a significant improvement 1 week after surgery was observed in the UBLIF group (3.8 ± 1.0 cm), while in the PLIF group the dynamics was insignificant (5.2 ± 1.1 cm); the index of back pain in the PLIF group significantly improved only after 1 year (in PLIF – 3.4 ± 1.4 cm, in UBLIF – 3.1 ± 0.8 cm). Assessing the quality of life, positive dynamics by Oswestry Disability Index (ODI) was observed during 1 year of observation in both groups (UBLIF 32.7 ± 5.6 %, in PLIF 29.2 ± 10.1 %), no significant differences in the frequency of complications between the groups were revealed. Conclusions. UBLIF is less invasive compared to PLIF, however, UBLIF requires more time for surgery than PLIF. When performing PLIF surgery, the positive aspect is shorter surgery time, negative – a greater number of patients requiring blood transfusion than with UBLIF surgery.

Keywords

• unilateral biportal endoscopic lumbar interbody fusion
• posterior lumbar interbody fusion