Meta-Analysis of the Clinical Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion versus Endoscopic Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases

To compare the efficacy and safety of unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) and endoscopic lumbar interbody fusion (Endo-LIF) in the treatment of lumbar degenerative diseases in lumbar degenerative diseases. A thorough literature search was conducted according to the PRISMA guidelines and the PICO framework(PROSPERO 2024CRD42024592073). The databases searched included PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure(CNKI), and Wanfang Database, with a time frame of January 2020 to June 2024. Outcome metrics included operative time, rate of progress of surgical time for beginners, intraoperative bleeding, hidden blood loss(HBL), total blood loss(TBL), postoperative drainage, hospitalization time, visual analog score (VAS) for pain, Oswestry Disability Index (ODI), complications, fusion rates, and modified MacNab score excellence rates. A total of 10 papers were included, including two that were RCT trials. This study involved 710 patients, 348 in the UBE-LIF group and 362 in the Endo-LIF group. The results showed that the UBE-LIF group was superior to the Endo-LIF group in terms of operative time and rate of progress of surgical time for beginners. In contrast, the Endo-LIF group was superior to the UBE-LIF group in terms of hospitalization time, hidden blood loss, and total blood loss. There were no statistical differences between the two procedures regarding intraoperative bleeding, postoperative drainage, visual analog score for low back pain, Oswestry Disability Index, complications, fusion rates, and modified MacNab score excellence rates. Postoperative pain and safety were comparable between the two endoscopic procedures.The UBE-LIF procedure was shorter, whereas the Endo-LIF had less total blood loss and a shorter recovery time.