Objective: To explore the safety and the mid-term efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and 3D microscope-assisted transforaminal lumbar interbody fusion (MMIS-TLIF) for treating single-segment lumbar spondylolisthesis with lumbar spinal stenosis (DLS-LSS). Methods: The clinical data of 49 patients who underwent UBE-TLIF or MMIS-TLIF in our hospital were retrospectively analyzed, including 26 patients who underwent the UBE-TLIF and 23 patients who underwent the MMIS-TLIF. The demographic and perioperative outcomes of patients before and after surgery were reviewed. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the clinical outcomes of patients before surgery and at 1, 3, 6, 12 and 24 months after surgery. The lumbar lordosis angle (LL), disc height (DH) and lumbar intervertebral fusion rate were assessed before surgery and at the last follow-up. Results: The VAS and ODI scores of the two groups were improved compared with those before surgery. The ODI of UBE-TLIF group was lower than that of MMIS-TLIF group at 1, 3, 6, and 12 months after surgery, and there were no significant differences between the two groups at other time points (P > 0.05). There were no significant differences in VAS between the two groups at each time point (P > 0.05). However, the UBE-TLIF group had more advantages in blood loss and hospital stay. The complications between the UBE-TLIF group (11.54%) and the MMIS-TLIF group (17.39%) were comparable (P > 0.05). Radiographic outcomes showed that the LL and DH of the two groups were improved compared with those before surgery, and the difference before and after surgery was not significant (P > 0.05). The fusion rate was 96.2% in the UBE-TLIF group and 95.7% in the MMIS-TLIF group. There was no significant difference in the fusion rate between the two groups (P > 0.05). Conclusions: Both UBE-TLIF and MMIS-TLIF have favorable outcomes for treating single-segment DLS-LSS. Both groups have the advantages of clear surgical vision, high surgical efficiency, and favorable mid-term efficacy. In addition, compared with MMIS-TLIF, UBE-TLIF causes less intraoperative bleeding and faster postoperative recovery.

Study Design.: A systematic review and meta-analysis. Objective.: This study systematically reviewed and evaluated the safety and efficacy of spinal endoscopic techniques as a treatment for thoracic ligamentum flavum ossification (TOLF). Summary of Background Data.: The use of spinal endoscopic techniques for the treatment of TOLF has increased in recent years. The present study is the first comprehensive systematic review and meta-analysis focused on the use of spinal endoscopic techniques for TOLF. Materials and Methods.: The Cochrane Central, PubMed, Web of Science, and Embase databases were systematically searched for studies focused on patients undergoing spinal endoscopic techniques to treat symptomatic TOLF. Results.: This meta-analysis included 23 studies. We included 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years, with 304 total recorded lesion locations of which 245 were located in the lower thoracic spine. Complications affected 35/323 patients, and the mean operative duration for 305 patients was 108.15±47.34 minutes. For 187 patients, the mean operative bleeding was 25.13±12.54 mL, while for 87 patients the mean duration of hospitalization was 4.59±1.93 days. At last follow-up, functional assessment was performed for 260 patients, of whom 200 were in excellent condition, visual analog scale (VAS) scores were assessed for 160 patients, with a mean improvement of 4.40 (3.95, 4.86) Japanese Orthopedic Association (JOA) scores were recorded for 115 patients, with a mean improvement of 3.49 (2.79,4.18), and modified Japanese Orthopedic Association (mJOA) scores were recorded for 208 patients, with a mean improvement of 3.62 (2.89,4.35). Conclusions.: These results support several advantages of spinal endoscopic techniques for the treatment of symptomatic TOLF. These include low complication rates, rapid postoperative recovery, and good functional recovery when used for single-segment, non-nodular ossification and no combined dural ossification.

Objcetive: To explore the safety the mid-term efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion ( UBE-TLIF ) and 3D microscope-assisted transforaminal lumbar interbody fusion ( MMIS-TLIF ) in the treatment of single-segment lumbar spondylolisthesis with lumbar spinal stenosis ( DLS-LSS ).。Methods The clinical data of 49 patients who underwent UBE-TLIF or MMIS-TLIF in our hospital from September 2019 to March 2021 were retrospectively analyzed. Among them, 26 patients underwent UBE-TLIF and 23 patients underwent MMIS-TLIF. The demographic and perioperative outcomes of patients before and after surgery were reviewed. Visual analogue scale ( VAS ) and Oswestry disability index ( ODI ) were used to evaluate the clinical outcomes of patients before operation and at 1 month, 3 months, 6 months, 12 months and 24 months after operation. The lumbar lordosis angle ( LL ), disc height ( DH ) and lumbar intervertebral fusion rate were assessed before operation and at the last follow-up.Results The VAS and ODI of the two groups were improved compared with those before operation. The ODI of UBE-TLIF was lower than that of MMIS-TLIF at 1 month, 3 months, 6 months and 12 months after operation, and there was no significant difference between the two groups at other time points ( P > 0.05 ). There was no significant difference in VAS between the two groups at each time point ( P > 0.05 ). However, UBE-TLIF had more advantages in blood loss and hospital stay. The complications between the UBE-TLIF (11.54%) and the MMIS-TLIF (17.39%) were minor ( P > 0.05 ). Radiographic outcomes showed that the LL and DH of the two groups were improved compared with those before operation, and the difference before and after operation was not significant ( P > 0.05 ). The fusion rate was 96.2% in the UBE-TLIF group and 95.7% in the MMIS-TLIF group. There was no significant difference in the fusion rate between the two groups ( P > 0.05 ).Conclusions Both UBE-TLIF and MMIS-TLIF have favorable outcomes in the treatment of single-segment DLS-LSS. They have the advantages of clear surgical vision, high surgical efficiency, and favorable mid-term efficacy. In addition, compared with MMIS-TLIF, UBE-TLIF causes less intraoperative bleeding and faster postoperative recovery.