ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicEndoscopy, Navigation, Robotics, Current Trends and Newer Technologies in the Management of Spinal Disorders. Towards a Paradigm Change in the Clinical Practice.View all 9 articles
Comparison of Clinical Efficacy of Unilateral Biportal Endoscopic Lumbar Interbody Fusion and Osterior Lumbar Interbody Fusion in the Treatment of L4/5 Lumbar Disc Herniation
Provisionally accepted
- Yangtze University Jingzhou Hospital, Jingzhou, China
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Objective To compare the clinical efficacy between unilateral biportal endoscopic lumbar interbody fusion (ULIF) and traditional posterior lumbar interbody fusion (PLIF) in the treatment of L4/5 lumbar disc herniation (LDH). Methods A total of eighty-five patients with L4/5 LDH were enrolled and assigned into two groups: the ULIF group (n=37) and the PLIF group (n=48).. Data regarding surgical conditions, hospital stay, perioperative Visual Analogue Scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, and serum inflammatory factor levels were recorded. Results No statistically significant differences were observed in preoperative clinical characteristics (including age, disease duration, BMI, gender distribution, preoperative VAS scores, JOA scores, and serum inflammatory factor levels) between the two groups (all P > 0.05), indicating good comparability. Compared with the PLIF group, the ULIF group was associated with significantly less intraoperative blood loss, reduced postoperative drainage volume, and a shorter postoperative hospital stay (all P < 0.05). Additionally, the ULIF group exhibited lower serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) at 24 hours postoperatively, as well as significantly lower VAS scores and higher JOA scores at 7 and 30 days postoperatively (all P < 0.05). However, the ULIF group was associated with a longer operative time and a higher number of intraoperative C-arm fluoroscopies compared with the PLIF group (both P < 0.05). Conclusion ULIF exhibits significant advantages in minimally invasive. Although it requires longer operative time and more intraoperative fluoroscopies, it is associated with reduced blood loss, attenuated inflammatory responses, shorter hospital stay, and superior early postoperative pain and functional recovery, facilitating patient rehabilitation.
Keywords: Unilateral biportal endoscopic technique, Lumbar disc herniation, ULIF, PLIF, L4/5
Received: 07 Oct 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 Deng, Yang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yongtao Xu
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