Effects of unilateral biportal endoscopic transforaminal lumbar interbody fusion on paraspinal muscles

Wang Qianliang; Zhang Qianzhongyi; Peng Yujian; Yan Jun

doi:10.12307/2025.831

Abstract：BACKGROUND:With the development of unilateral biportal endoscopic technology,endoscopic lumbar fusion surgery has become an increasingly popular development trend in spinal surgery.Unilateral biportal endoscopic transforaminal lumbar interbody fusion shows significant advantages for preserving paravertebral muscle and reducing intraoperative bleeding in spinal stenosis and lumbar spondylolisthesis in the lumbar spine with degenerative changes. OBJECTIVE:To compare the effects of unilateral biportal endoscopic lumbar interbody fusion and traditional open transluminal lumbar interbody fusion on paraspinal muscles. METHODS:A retrospective analysis was conducted on the clinical data of 60 patients who visited the Department of Spine Surgery,Second Affiliated Hospital of Soochow University from October 2019 to November 2022 and underwent single segment unilateral decompression fusion.They were divided into two groups according to different surgical procedures.Group A received unilateral biportal endoscopic lumbar interbody fusion.Group B received traditional open transluminal lumbar interbody fusion.All patients underwent magnetic resonance imaging examination before and 3 months after surgery.Basic patient information,last follow-up time,magnetic resonance imaging images,visual analog scale scores for lower back and leg pain,and Oswestry Disability Index were collected. RESULTS AND CONCLUSION:(1)Three months after surgery,the cross-sectional area of the bilateral multifidus muscle in group A was significantly larger than that of group B(P＜0.05),and the degree of fat infiltration was lower(P＜0.01).(2)There was no significant difference in the cross-sectional area and degree of fat infiltration of bilateral erector spinae muscles between the two groups 3 months after surgery(P＞0.05).(3)It is concluded that unilateral biportal endoscopic lumbar interbody fusion is more effective than traditional open transluminal lumbar interbody fusion in protecting multifidus muscle,reducing multifidus muscle atrophy and fat infiltration.Both surgical methods did not have a significant impact on the erector spine muscle.