Clinical Efficacy of Unilateral Biportal Endoscopic Transforaminal Lumbar Interbody Fusion Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion in the Treatment of Mild Degenerative Lumbar Spondylolisthesis

Objective To compare the clinical and radiological outcomes of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of single-level mild degenerative lumbar spondylolisthesis. Methods A retrospective analysis was conducted on 80 patients with single-level mild degenerative lumbar spondylolisthesis, including 40 patients treated with UBE-TLIF and 40 patients treated with MIS-TLIF. Perioperative parameters, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), modified MacNab scores, fusion rates, trabecular bone remodeling (TBR) at 3 months postoperatively, and multifidus atrophy and fat infiltration rates at 12 months postoperatively were compared between the two groups. Results The UBE-TLIF group demonstrated significantly less intraoperative blood loss and shorter hospital stays, but longer operative times compared with the MIS-TLIF group (all P < 0.01). At 3 days postoperatively, the VAS score for low back pain was significantly lower in the UBE-TLIF group than in the MIS-TLIF group (P < 0.05), whereas no significant differences were observed between groups in VAS, ODI, or modified MacNab scores at other time points (P > 0.05). The UBE-TLIF group showed significantly higher TBR positivity at 3 months and a higher fusion rate at 6 months postoperatively compared with the MIS-TLIF group (P < 0.05), while no significant difference in fusion rate was observed at 12 months. At 12 months postoperatively, the multifidus atrophy rate and fat infiltration rate were both significantly lower in the UBE-TLIF group than in the MIS-TLIF group (P < 0.05). Conclusion Both UBE-TLIF and MIS-TLIF provide satisfactory clinical outcomes in the treatment of single-level mild degenerative lumbar spondylolisthesis. Compared with MIS-TLIF, UBE-TLIF demonstrates certain advantages in early postoperative pain relief, preservation of paraspinal muscles, and early osteointegration during the fusion process.