Objective To compare the clinical efficacy of uniportal endoscopic lumbar interbody fusion (Endo-LIF) and unilateral biportal endoscopy (UBE) in the treatment of lumbar degenerative diseases. Methods The clinical data of 180 patients with lumbar degenerative diseases who underwent single-segment endoscopic interbody fusion were retrospectively analyzed. Patients were divided into the Endo-LIF group (n=89) and the UBE group (n=91) according to surgical approaches. Operative duration, intraoperative blood loss, total incision length, length of hospital stay and postoperative complications were compared between the two groups. The visual analogue scale (VAS) scores for pain were used to evaluate lumbodynia and leg pain before surgery, at 3 months after surgery and at the final follow-up. The Oswestry disability index (ODI) was adopted to assess lumbar function. The improvement rate of ODI score was used to evaluate clinical efficacy at the final follow-up. Imaging examinations were performed before surgery and at 1 week after surgery to compare spinal canal area, intervertebral space height, lumbar lordosis angle and interbody fusion rate between the two groups. Results Complete follow-up data were obtained in 176 patients, with a follow-up rate of 97.78%, including 85 patients in the Endo-LIF group and 91 patients in the UBE group. The follow-up duration ranged from 12 to 36 months, with a mean of (24.27±6.78) months. Compared with the UBE group, the Endo-LIF group had longer operative duration, less intraoperative blood loss and shorter total incision length (P<0.05). There was no significant difference in length of hospital stay between the two groups (P>0.05). The lumbodynia VAS scores, leg pain VAS scores and ODI scores at 3 months postoperatively and final follow-up were significantly lower than the preoperative values in both groups (P<0.05). At the final follow-up, the lumbodynia VAS score and ODI score in the UBE group were lower than those in the Endo-LIF group (P<0.05), whereas no significant difference was found in leg pain VAS score between the two groups (P>0.05). No significant differences were observed in clinical efficacy and effective rate between the two groups (P>0.05). The excellent and good rate in the UBE group was higher than that in the Endo-LIF group (P<0.05). Postoperatively, spinal canal area, intervertebral space height and lumbar lordosis angle were improved compared with preoperative status in both groups (P<0.05), while there were no significant intergroup differences in the above radiological indicators (P>0.05). At the final follow-up, the interbody fusion rate showed no significant difference between the two groups (P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion Both Endo-LIF and UBE are safe and effective minimally invasive fusion procedures for lumbar degenerative diseases, with comparable interbody fusion rates and surgical safety. Endo-LIF causes less trauma and less intraoperative blood loss, which is suitable for patients with mild spinal stenosis and predominant unilateral symptoms. UBE yields better long-term improvement in lumbar function and is appropriate for complex cases requiring thorough bilateral decompression.

无