• Xiaofeng Yuan, Rui Tao, Mengfei Zhu, and Jiajun Zhu.
• Department of Spine Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China.
• World Neurosurg. 2024 Dec 7.

ObjectiveTo evaluate the clinical efficacy of large-channel endoscope-assisted posterior lumbar interbody fusion (Endo-PLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), and open posterior lumbar interbody fusion in the treatment of degenerative diseases of the lumbar spine.MethodsThe data of 110 patients with degenerative diseases of the lumbar spine were analyzed retrospectively: 31 cases had Endo-PLIF, 36 patients received MIS-TLIF, and 43 cases underwent modified-TLIF. We compared several parameters among the three groups: operative duration; intraoperative blood loss; latent blood loss; intraoperative radiation dose; visual analog scale (VAS) score; Oswestry Disability Index (ODI); anterior protrusion angle of the intervertebral space; postoperative ambulatory time; postoperative duration of hospital stay; complications. The prevalence of interbody fusion was observed at follow-up.ResultsThe operative duration of Endo-PLIF was longer than that of MIS-TLIF and modified-TLIF (P <0.05). In terms of intraoperative blood loss, latent blood loss, and recovery time, Endo-PLIF and MIS-TLIF had clear advantages (P <0.05). The VAS score and ODI of the three groups were satisfactory, but the low-back pain of patients in the Endo-PLIF group and MIS-TLIF group was less than that in the modified-TLIF group (P <0.05). In terms of complications and prevalence of interbody fusion, there were no significant differences among the three groups (P >0.05).ConclusionAll three operative methods had satisfactory efficacy. Endo-PLIF can be employed to treat lumbar degenerative diseases more precisely and in a minimally invasive fashion, but a learning curve and improvement in surgical instruments are needed.Copyright © 2024. Published by Elsevier Inc.

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