Comparison of clinical outcomes between unilateral biportal endoscopic transforaminal lumbar interbody fusion and oblique lumbar interbody fusion with posterior percutaneous screw fixation in patients with lumbar spinal canal stenosis

Purpose This study aims to evaluate the clinical outcomes of unilateral biportal endoscopic transforaminal lumbar interbody fusion (ULIF) and oblique lumbar interbody fusion with posterior percutaneous screw fixation (OLIF-PF) in the treatment of lumbar spinal canal stenosis (LSCS). Methods Data from December 2019 to January 2022 were analyzed. 54 patients in the ULIF group and 42 patients in the OLIF-PF group completed a minimum of 1 year follow-up. The demographic data, clinical indicators, laboratory indicators, radiological results, and complications were assessed and compared between the two groups. Results There was no significant difference in the preoperative baseline between the two groups. The ULIF group experienced shorter operation time and more blood loss compared with the OLIF-PF group ( P < 0.05). The VAS for back pain and ODI score at 1 day postoperatively were lower in the OLIF-PF group than in the ULIF group. At the last follow-up, the VAS for back pain was lower in the ULIF group than in the OLIF-PF group ( P < 0.05). However, the VAS for leg pain was lower in the ULIF group than in the OLIF-PF group at 1 day postoperatively, and there were no significant differences at other follow-up times ( P < 0.05). There was no significant difference between the two groups in the modified MacNab score at last follow-up (90.74% vs. 90.48%, P > 0.05). And there was no significant difference between the two groups in CPR and ESR ( P > 0.05). The improvements of DH, LL, and SA were superior in the OLIF-PF group than in the ULIF group at 3 days postoperatively and maintained to the last follow-up ( P < 0.05). Conclusions Both ULIF and OLIF-PF showed favorable mid-term outcomes in the treatment of LSCS. Both surgical methods significantly improved pain symptoms and lumbar sagittal balance. Long-term follow-up and larger clinical studies are needed to confirm this result.