Tao Ma ^* Senlin Chen ^* Junyang Li ^* Yongcun Geng ^* Jingwei Wu ^* Xiaoshuang Tu ^* Dengming Yan ^* Ming Jiang ^* Gongming Gao ^* Luming Nong ^*

• Changzhou No.2 People's Hospital, Changzhou, China

Objective: To study the clinical efficacy of unilateral biportal endoscopic lumbar interbody fusion (ULIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar degenerative diseases, a resulting from these two different surgical methods.Background: Transforaminal lumbar interbody fusion (TLIF) is widely acknowledged as an efficacious surgical modality for alleviating low back pain. .Methods:We recorded the basic information of patients who underwent single-segment ULIF or TLIF for the first time in our hospital from May 2021 to November 2022, including age, gender, BMI, diagnosis, and surgical segment. Perioperative indicators such as estimated blood loss, operation time, postoperative hospital stay, and complications were observed in both groups. Clinical efficacy was assessed preoperatively and at 1 month, 3 months, and 12 months postoperatively using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). The Cobb angle was used to measure lumbar lordosis and segmental lumbar lordosis. MRI at 1 year postoperatively was used to manually trace the cross-sectional area of the paraspinal muscles to compare muscle atrophy. Results: A total of 150 patients were included in the study, with 71 patients in the ULIF group and 79 patients in the TLIF group. No statistically significant disparities were observed between the two groups with respect to age, gender, BMI, diagnosis, and surgical segment. Patients in the ULIF group experienced quicker relief from back pain postoperatively, but there were no significant differences between the ULIF and TLIF groups in the VAS, ODI, and satisfaction rates at the final follow-up. At 3 months postoperatively, the ULIF group demonstrated a higher incidence of bridging trabeculae, a lower incidence of endplate cysts, and less fusion device displacement. There were no significant differences between the two groups in the correction of segmental lumbar lordosis (SL) and overall lumbar lordosis (LL). Additionally, the ULIF group showed less muscle damage.Conclusion: ULIF has the advantages of reducing pain in the short term, less blood loss, and shorter hospital stays. Its more precise handling of the intervertebral space reduces the occurrence of endplate cysts and fusion device displacement, which has certain significance in preventing delayed fusion and nonunion.