Unilateral Biportal Endoscopic Lumbar Interbody Fusion: A Technical Note and an Outcome Comparison with the Conventional Minimally Invasive Fusion

Gatam, Asrafi Rizki; Gatam, Luthfi; Mahadhipta, Harmantya; Ajiantoro, Ajiantoro; Luthfi, Omar; Aprilya, Dina

doi:10.2147/orr.s336479

Cited by 16 publications

(29 citation statements)

References 26 publications

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“…The Oswestry Disability Index at 1–2 weeks post-operatively could be obtained in four studies ( 28 , 31 , 32 , 35 ), and significant heterogeneity was detected ( I 2 = 92.2%, P < 0.001). The pooled results revealed significantly lower ODI at 1–2 weeks post-operatively in the ULIF group compared with that in the MI-TLIF group (WMD, −4.70; 95% CI −9.13 to −0.27, P = 0.038).…”

Section: Resultsmentioning

confidence: 99%

“…These findings may be attributed to the reduced atrophy, denervation, and ischemic paraspinal muscle damage caused by dissection and retraction ( 60 , 61 ). Furthermore, the endoscope provides a clear and magnified view, allowing more precise manipulation for the decompression of the central canal, lateral recess, and bilateral nerve roots ( 32 ). The study by Kim et al reported that there was no significant difference in the early and final ODI between unilateral biportal endoscopic and open microscopic techniques for lumbar discectomy ( 61 ).…”

Section: Discussionmentioning

confidence: 99%

“…The Visual Analog Scale score for back pain at 1-2 days post-operatively could be obtained in two studies (32,33), and no significant heterogeneity was detected (I 2 = 33.0%, P = 0.222). The pooled results revealed significantly lower VAS-BP at 1-2 days post-operatively in the ULIF group compared with that in the MI-TLIF group (WMD, −1.22; 95% CI −1.30 to −1.13, P < 0.001).…”

Section: Visual Analog Scale Score For Back Pain One To Two Days Post...mentioning

confidence: 99%

“…The incidence of unplanned return to OR could be obtained in four studies (32)(33)(34)(35), and no substantial heterogeneity was detected (I 2 = 0.0%, P = 0.689). The pooled results revealed no significant difference in the incidence of unplanned return to OR between the ULIF group and the MI-TLIF group (RR, 0.76; 95% CI 0.20-2.93, P = 0.687).…”

Section: Unplanned Return To the Operating Room Ulif Vs Mi-tlifmentioning

confidence: 99%

“…The overall surgical complication rate during the perioperative period could be obtained in seven studies (29)(30)(31)(32)(33)(34)(35), and no substantial heterogeneity was detected (I 2 = 0.0%, P = 0.992). The pooled results revealed no significant difference in the overall surgical complication rate between the ULIF group and the MI-TLIF group (RR, 0.96; 95% CI 0.53-1.74, P = 0.896; Figure 10A).…”

Section: Overall Ulif Vs Mi-tlifmentioning

confidence: 99%

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Unilateral biportal endoscopic lumbar interbody fusion enhanced the recovery of patients with the lumbar degenerative disease compared with the conventional posterior procedures: A systematic review and meta-analysis

Yang

Cheng²,

Hai³

et al. 2023

Front. Neurol.

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BackgroundMinimally invasive endoscopic technique is an important component of Enhanced Recovery After Surgery (ERAS) protocol for neurosurgery. In recent years, unilateral biportal endoscopic lumbar interbody fusion (ULIF) has been used in the treatment of lumbar degenerative diseases (LDD). This study aims to investigate whether ULIF could enhance the recovery of patients with LDD compared with the conventional minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) or posterior lumbar interbody fusion (PLIF).MethodsA comprehensive literature search was performed for relevant studies in PubMed, EMBASE, Web of Science, Cochrane Library database, China National Knowledge Internet, and Wanfang database. Surgical data, clinical outcomes, radiographic outcomes, and surgical complications were compared between patients with LDD who underwent ULIF and those who underwent conventional MI-TLIF or PLIF.ResultsNotably, 12 studies, comprising 981 patients with LDD, were included. Of these patients, 449 underwent ULIF and 532 patients (355 MI-TLIF and 177 PLIF) were treated with conventional procedures. There was no significant difference in the fusion rate, cage subsidence rate, and surgical complications between the ULIF group and the MI-TLIF or PLIF group. Compared with MI-TLIF, the ULIF group presented a significantly reduced estimated blood loss (EBL) (WMD, −106.00; 95% CI −140.99 to −71.10, P < 0.001) and shorter length of hospital stay (LOS) (WMD, −1.27; 95% CI −1.88 to −0.66, P < 0.001); better short-term improvement in ODI (WMD, −2.12; 95% CI −3.53 to −0.72, P = 0.003) and VAS score for back pain (VAS-BP) (WMD, −0.86; 95% CI −1.15 to −0.58, P < 0.001) at 1 month post-operatively. Compared with PLIF, the ULIF group presented a significantly reduced EBL (WMD, −149.22; 95% CI −284.98 to −13.47, P = 0.031) and shorter LOS (WMD, −4.40; 95% CI −8.04 to −0.75, P = 0.018); better short-term improvement in VAS-BP (WMD, −1.07; 95% CI −1.77 to −0.38, P = 0.002) and VAS score for leg pain (VAS-LP) (WMD, −0.40; 95% CI −0.72 to −0.08, P = 0.014) at 1–2 week post-operatively; enhanced short- and long-term improvement in ODI at 1 month post-operatively (WMD, −3.12; 95% CI −5.72 to −0.53, P = 0.018) and the final follow-up (WMD, −1.97; 95% CI −3.32 to −0.62, P = 0.004), respectively.ConclusionCompared with conventional MI-TLIF and PLIF, ULIF was associated with reduced EBL, shorter LOS, and comparable fusion rate as well as complication management. Compared with MI-TLIF, a better short-term improvement in VAS-BP and ODI was achieved by ULIF; compared with open PLIF, additional enhanced short-term improvement in VAS-LP and long-term improvement in ODI were observed in ULIF. ULIF could enhance the recovery of patients with LDD compared with conventional posterior procedures.Systematic trial registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=230695, CRD42021230695.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Visual Analog Scale Score For Back Pain One To Two Days Post...mentioning

confidence: 99%

Section: Unplanned Return To the Operating Room Ulif Vs Mi-tlifmentioning

confidence: 99%

Section: Overall Ulif Vs Mi-tlifmentioning

confidence: 99%

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Unilateral biportal endoscopic lumbar interbody fusion enhanced the recovery of patients with the lumbar degenerative disease compared with the conventional posterior procedures: A systematic review and meta-analysis

Yang

Cheng²,

Hai³

et al. 2023

Front. Neurol.

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Comparing the efficacy and complications of unilateral biportal endoscopic fusion versus minimally invasive fusion for lumbar degenerative diseases: a systematic review and mate-analysis

et al. 2023

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“Early Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion Versus Minimal Invasive in the Treatment of Lumbar Degenerative Diseases”

Qin

Pan

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Study Design: This was a retrospective cohort study. Objective: To compare the early clinical efficacy and radiologic outcomes between unilateral biportal endoscopic lumbar interbody fusion (ULIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Summary of Background Data: Along with the continuous development of endoscopic technology, the early safety and effectiveness of ULIF technology are still unknown. Materials and Methods: This retrospective study included 61 patients who underwent fusion surgery through ULIF or MIS-TLIF in 2021. Twenty-nine patients underwent ULIF (group A), and 32 underwent MIS-TLIF (group B). Fusion rate, bone graft volume, hidden blood loss (HBL), C-reactive protein level, operative time, Oswestry Disability Index , Visual Analog Scale score, and MacNab criteria were assessed in both groups. Results: The Visual Analog Scale score for back pain in the early postoperative period was significantly lower in group A than in group B (P<0.05). All other clinical scores showed improvement, with no significant difference between the 2 groups (P>0.05). There was no statistically significant difference in postoperative C-reactive protein levels and fusion rates between the 2 groups (P>0.05). However, HBL was higher and operative time was longer in group A than in group B (P<0.05). Most importantly, there were no statistically significant differences between groups A and B in fusion rate, length of stay and bone graft volume (P>0.05). No serious surgical complications occurred in our study. Conclusions: ULIF is a new option for lumbar fusion. Despite the drawbacks of longer operation time and higher HBL, ULIF may be a viable alternative to MIS-TLIF as technology advances.

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Unilateral Biportal Endoscopic Lumbar Interbody Fusion: A Technical Note and an Outcome Comparison with the Conventional Minimally Invasive Fusion

Cited by 16 publications

References 26 publications

Unilateral biportal endoscopic lumbar interbody fusion enhanced the recovery of patients with the lumbar degenerative disease compared with the conventional posterior procedures: A systematic review and meta-analysis

Unilateral biportal endoscopic lumbar interbody fusion enhanced the recovery of patients with the lumbar degenerative disease compared with the conventional posterior procedures: A systematic review and meta-analysis

Comparing the efficacy and complications of unilateral biportal endoscopic fusion versus minimally invasive fusion for lumbar degenerative diseases: a systematic review and mate-analysis

“Early Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion Versus Minimal Invasive in the Treatment of Lumbar Degenerative Diseases”

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