Endo-PLIF vs MIS-TLIF in elderly lumbar degenerative disease shows reduced blood loss and hospital stay

BackgroundLumbar 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.MethodsA 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.ResultsAll procedures were successfully completed in both cohorts, with a follow-up period of more than 12 months. No statistically significant difference was observed in operative time between the two groups (P > 0.05). The Endo-PLIF group demonstrated significantly superior outcomes regarding intraoperative blood loss, postoperative drainage volume and length of hospital stay (P