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Endo-PLIF vs MIS-TLIF in elderly lumbar degenerative disease shows reduced blood loss and hospital stayFor elderly spine patients, one small incision surgery may mean less blood loss and a shorter hospital stay

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Key Takeaway
Consider Endo-PLIF for reduced blood loss and hospital stay in elderly lumbar disease, but evidence is observational.

This retrospective comparative study involved 77 elderly patients with lumbar degenerative diseases from the Department of Spinal Minimally Invasive Surgery at Guangdong Provincial Hospital of Traditional Chinese Medicine. Patients were divided into two groups: 35 underwent uniportal endoscopic posterior lumbar interbody fusion (Endo-PLIF) and 42 underwent minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), with follow-up over 12 months. The primary outcome was not explicitly defined, but secondary outcomes included operative time, intraoperative blood loss, postoperative drainage volume, length of hospital stay, and others.

Main results showed no statistically significant difference in operative time between groups (P > 0.05). Endo-PLIF demonstrated significantly superior outcomes for intraoperative blood loss, postoperative drainage volume, and length of hospital stay (all P < 0.05), with Endo-PLIF better, though absolute numbers and effect sizes were not reported. Other outcomes like Visual analogue score, Oswestry Disability Index, serum C-reactive protein levels, radiographic parameters, modified MacNab criteria, and incidence of postoperative complications were assessed but results were not detailed in the input.

Safety data indicated all procedures were successfully completed in both cohorts, with incidence of postoperative complications reported as a comparison metric but specific rates not provided. Serious adverse events and discontinuations were not reported. Limitations include the observational nature of the study, which precludes causal inferences, and lack of reported absolute numbers, funding, or conflicts. Practice relevance was not reported, so these findings should be considered preliminary and require confirmation in more rigorous trials.

Imagine having back surgery while elderly. You want to get back to your life quickly with as little pain as possible. This study compared two modern techniques for fixing lumbar degenerative diseases, which are wear-and-tear issues in the lower spine. One method, called Endo-PLIF, uses a single small incision. The other, MIS-TLIF, uses slightly larger openings and tubes that can press on soft tissue. Researchers looked at 77 patients in a hospital in Guangdong, China, to see how these two approaches compared.

The team tracked several things carefully, including how much blood was lost during the operation and how long patients stayed in the hospital. They also measured pain levels and how well the spine healed over more than 12 months. The findings showed that the single-incision surgery led to significantly less blood loss and less fluid draining from the wound afterward. Patients also spent less time in the hospital with the single-incision method.

However, the time it took to perform the surgery was about the same for both methods. While the single-incision approach seemed to offer advantages in recovery, this study involved a relatively small number of patients. The results are promising, but they come from one specific hospital setting. This means we cannot yet say for sure that this method is superior for every patient everywhere.

What this means for you:
A single-incision spine surgery may reduce blood loss and hospital stay for elderly patients with back problems, but larger studies are needed.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
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 
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