Comparison of early clinical efficacy of percutaneous endoscopic transforaminal lumbar decompression and single-level lumbar intervertebral fusion in the treatment of lumbar degenerative spondylolisthesis with lumbar spinal stenosis

Background The clinical efficacy of decompression alone with and without fusion in the treatment of lumbar degenerative spondylolisthesis (LDS) with lumbar spinal stenosis (LSS) remains controversial, and this article compares the efficacy of percutaneous transforaminal lumbar discectomy (PTED) with that of lumbar decompression fusion in the treatment of LDS with LSS. Method From August 2018 to December 2020, 54 consecutive patients were diagnosed with LSS with DLS at our institution, 26 were treated with PTED, and 28 underwent single-segment lumbar fusion surgery. All patients were followed up for at least 1 year after surgery. Clinical outcomes were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified Macnab’s criteria. Results The mean age was 65.81 ± 8.04 years in the PTED group and 63.29 ± 4.60 years in the decompression fusion group. At 1 year postoperatively, the VAS and ODI scores of patients in both groups showed significant improvement compared with the preoperative scores (p < 0.05), with no significant difference between the two groups eventually. At 3 and 6 months postoperatively, the ODI values of patients in both groups were statistically significant (p < 0.05), and the postoperative recovery was faster in the PTED group than in the decompression fusion group. According to the modified Macnab criteria, the excellent rates were 92.31% and 92.86% in the PTED group and the decompression fusion group, respectively. And the operative time, blood loss, postoperative hospital stay, off-bed time and complication rate were significantly shorter in the PTED group. There was no significant difference in preoperative radiological parameters between the two groups. At the last follow-up, there was no significant difference in the slippage rate between the two groups. Conclusion The advantages of the PTED group over the decompression fusion group are faster postoperative recovery, less bleeding, and less trauma.There was no significant difference in the short-term clinical outcomes between the two groups, and the long-term outcomes and complications still need to be further explored and validated.