Comparison of learning curves and clinical efficacy of two endoscopic techniques for single segment lumbar degenerative disease

To compare the clinical outcomes and learning curve characteristics of unilateral biportal endoscopic lumbar interbody fusion (UBE-TLIF) and percutaneous uniportal full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) in patients with single-segment lumbar degenerative diseases (LDD). A retrospective study was conducted from January 2022 to July 2023, involving a total of 95 patients with single-segment LDD, who were divided into two groups: the Endo-TLIF group and the UBE-TLIF group. The demographic characteristics, radiographic and clinical outcomes, as well as complications were meticulously recorded and analyzed in both groups. The mean operation time of Endo-TLIF group was 224.08 ± 58.90 min, which was significantly longer than that of UBE-TLIF group (169.93 ± 30.86 min) (P < 0.05). The perspective times were significantly shortened in the UBE-TLIF group compared with the Endo-TLIF group (P < 0.05). The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores showed significant improvement post-operation in both groups (P < 0.05). There were no significant differences in VAS, ODI and modified Macnab criteria during the last follow-up periods (P > 0.05). Both groups exhibited similar complication rates and fusion rates (P > 0.05). CUSUM analysis indicated that the stabilization of operation time occurred after 23 cases for Endo-TLIF and 19 cases for UBE-TLIF, respectively. The safety and efficacy of both Endo-TLIF and UBE-TLIF for the treatment of LDD have been demonstrated. As the number of surgeries increased, the operation time for both procedures decreased. Specifically, after 23 surgeries, the operation time for Endo-TLIF reached a relative stability, while for UBE-TLIF it was achieved after 19 surgeries.