Uniportal endoscopic posterior lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion for elderly patients with lumbar degenerative diseases: a retrospective comparative study of reduced surgical trauma and accelerated

Background: Lumbar degenerative diseases are prevalent spinal disorders among the elderly population worldwide, significantly impairing their quality of life. Both minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and uniportal endoscopic posterior lumbar interbody fusion (Endo-PLIF) are established minimally invasive interbody fusion modalities for the management of these conditions. However, MIS-TLIF is associated with limitations such as soft tissue compression induced by dilator tubes and a comparatively prolonged postoperative recovery period. In the present study, we aimed to compare the clinical efficacy and radiographic outcomes of Endo-PLIF vs. MIS-TLIF in the treatment of lumbar degenerative diseases in elderly patients. Methods: A retrospective analysis was performed of 77 elderly patients with lumbar degenerative diseases who were admitted to the Department of Spinal Minimally Invasive Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, between September 2021 and March 2022. The patients were divided into two groups: 35 patients underwent Endo-PLIF and 42 patients underwent MIS-TLIF. The groups were compared in terms of operative time, intraoperative blood loss, length of hospital stay, Visual analogue score (VAS), Oswestry Disability Index (ODI), serum C-reactive protein (CRP) levels, radiographic parameters (including disc space height, lumbar lordosis angle, and fusion rate), the modified MacNab criteria, and the incidence of postoperative complications. Results: > 0.05). Conclusion: Both Endo-PLIF and MIS-TLIF achieve favorable short- to mid-term clinical and radiographic outcomes in elderly patients with lumbar degenerative diseases. Moreover, the Endo-PLIF technique offers additional advantages, including minimal invasiveness, reduced postoperative drainage, and facilitation of accelerated postoperative recovery.