Clinical Efficacy of OLIF, TLIF, and UBE-TLIF in the Treatment of Lumbar Disc Herniation—A Comprehensive Evaluation Based on Imaging and Inflammatory Indicators

AIM: Oblique Lateral Interbody Fusion (OLIF), Transforaminal Lumbar Interbody Fusion (TLIF), and Unilateral Biportal Endoscopy (UBE)-TLIF are widely used surgical approaches in the clinical treatment of Lumbar Disc Herniation (LDH). However, comparative studies on their efficacy remain insufficient. Therefore, this study aims to compare the clinical effectiveness of the three surgical approaches for treating LDH across multiple dimensions, providing evidence-based surgical decision-making tailored to individual patient requirements. METHODS: This retrospective study included 210 patients with LDH who underwent surgical treatment in our hospital between May 2021 and May 2024. They were divided into the OLIF group (n = 68), TLIF group (n = 72), and UBE group (n = 70) according to the surgical method, and all patients completed a follow-up of at least 3 months. Baseline characteristics of all three groups were collected, and perioperative indicators were compared and analyzed. The Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) were used to assess pain intensity and functional recovery in patients. Serum levels of C-reactive protein (CRP), D-dimer, and hemoglobin were used to assess inflammatory response and blood loss-related indicators. Differences in imaging indicators were also compared among the three groups. The types and incidence of postoperative complications were also assessed among these groups. RESULTS: No statistically significant differences were observed in the baseline data among the three groups (p > 0.05). The OLIF group had a significantly shorter operation time than the TLIF and UBE groups (p < 0.001) and a shorter hospital stay than the TLIF group (p < 0.05). The UBE group had significantly less intraoperative blood loss than the OLIF and TLIF groups (p < 0.05). At 3 months postoperatively, VAS and ODI scores were substantially lower for all three groups than the baseline values (p < 0.001), with no statistically significant differences among the three groups (p > 0.05). At postoperative day 3, serum CRP and D-dimer levels in all three groups were higher than the preoperative levels, whereas hemoglobin levels were lower (p < 0.001). However, the UBE group had lower CRP and D-dimer levels than the TLIF group (p < 0.05), and a smaller decrease in hemoglobin level than the TLIF group (p < 0.05). Imaging evaluation showed that the intervertebral space height was significantly restored in all three groups at 3 months postoperatively compared with preoperative values (p < 0.001), and there was no significant difference in the rate of good spinal canal decompression (p > 0.05). There was no significant difference in the total incidence among the three groups (p > 0.05). CONCLUSIONS: OLIF, TLIF, and UBE-TLIF are all effective in alleviating pain and improving lumbar function and have comparable safety profiles. OLIF is associated with shorter operative time and hospital stays, and UBE offers less surgical trauma as well as a milder early postoperative inflammatory response.