ArticleAsian spine journal2026
Unilateral biportal endoscopic transforaminal lumbar interbody fusion reduces paravertebral muscle atrophy and enhances recovery compared with Wiltse-transforaminal lumbar interbody fusion in lumbar degenerative disease: a retrospective study in a Chinese cohort.
Article in Asian spine journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
STUDY
designRetrospective study. PURPOSE: To compare postoperative paravertebral muscle atrophy, fat infiltration, and clinical efficacy between unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and Wiltse approach transforaminal lumbar interbody fusion (W-TLIF). OVERVIEW OF LITERATURE: The long-term effects of UBE-TLIF and W-TLIF techniques on paravertebral muscle integrity and clinical outcomes have not been directly compared.
methodsFifty patients who underwent UBE-TLIF and 50 patients who underwent W-TLIF, each with >2 years of follow-up, were retrospectively analyzed. Outcomes included operative parameters, time to postoperative mobilization, paravertebral muscle atrophy and fat infiltration rates, clinical scores (Visual Analog Scale [VAS], Oswestry Disability Index [ODI], Japanese Orthopaedic Association [JOA]), modified Macnab criteria, fusion rates, and complications.
resultsCompared with W-TLIF, the UBE-TLIF group had significantly less intraoperative blood loss, shorter operative times, and lower postoperative drainage volumes (p <0.05). The UBE-TLIF group showed faster postoperative recovery and shorter hospital stays. At 6 months, 1 year, and 2 years, W-TLIF patients had higher multifidus and erector spinae atrophy, and greater paravertebral muscle fat infiltration (p <0.05). The UBE-TLIF group also had lower VAS and ODI scores at 1 year and 2 years (p <0.05) and fewer surgical complications (6% vs. 10%). Fusion rates (94% vs. 92%) and modified Macnab outcomes (88% vs. 86%) were comparable (p >0.05).
conclusionsUBE-TLIF is associated with reduced intraoperative trauma, quicker recovery, and fewer complications. In the long-term, it better preserves paravertebral muscle integrity and provides superior pain and functional outcomes.
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