To investigate the application value of Unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) in the treatment of 98 cases of obesity-related single-segment degenerative lumbar disease, compared with Minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF).

A total of 98 obese patients with single segment degenerative lumbar disease admitted to Guangdong second traditional Chinese medicine hospital from January 2022 to January 2024 were selected for a prospective randomized controlled study. They were randomly divided into UBE-TLIF group and MIS-TLIF group using randomised numerical table method, 49 cases in each group. The perioperative conditions of the two groups were compared, as well as the visual analog scale (VAS) scores for waist and leg pain, lumbar lordotic angle (LL), disc height (DH), and Oswestry Disability Index (ODI) scores before surgery, and at 1 month and 6 months after surgery. The functional prognosis at 6 months after surgery and the incidence of postoperative complications were statistically analyzed.

All 98 patients were followed up for a complete period of 6 months postoperatively, with a follow-up rate of 100%. The total follow-up duration ranged from 6 to 29 months, with an average of (19.96±2.87) months. There were 56 males and 42 females, with an average age of 46.95±3.98 years. In the UBE-TLIF group, the intraoperative blood loss, postoperative drainage volume, and hospital stay were (249.68±31.59) ml, (94.23±18.55) ml, and (5.69±1.65) days, respectively, which were lower than those in the MIS-TLIF group [(327.95±28.11) ml, (123.61±20.39) ml, and (7.58±1.43) days], the operation time was (155.27±14.00) minutes, which was longer than that in the MIS-TLIF group [(136.39±11.94) minutes] (P<0.05). One month postoperatively, the VAS scores for low back pain and leg pain in the UBE-TLIF group were (2.00±0.51) and (1.78±0.48), respectively, both of which were lower than those in the MIS-TLIF group [(2.61±0.43) and (2.45±0.56)] (P<0.05). There were no significant differences in ODI, DH, and LL between the UBE-TLIF group and the MIS-TLIF group at 1 month and 6 months after surgery (P>0.05). The excellent and good rate of functional prognosis in the UBE-TLIF group at six months postoperatively was 95.92%, which was not significantly different from that in the MIS-TLIF group (91.84%) (P>0.05). The total incidence of complications in the UBE-TLIF group was 2.04%, which was not significantly different from that in the MIS-TLIF group (4.08%) (P>0.05).

The treatment of single-segment degenerative lumbar disease in obese patients using UBE-TLIF and MIS-TLIF procedures can achieve good efficacy and high safety. UBE-TLIF has the advantages of minimal intraoperative trauma, rapid postoperative recovery, and improved early pain relief. However, its surgical time is longer, and clinicians can choose the appropriate procedure based on specific circumstances.