Objective:

We compared the clinical outcomes of minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) and endoscopic transforaminal lumbar interbody fusion (Endo-TLIF).

Methods:

We retrospectively analyzed the clinical data of patients who underwent single-segment Mis-TLIF or Endo-TLIF between June 2016 and June 2019 at our hospital. The patients in each treatment group were matched 1:1 for sex, age, and type of lumbar degenerative disease, and their clinical outcomes were compared at discharge and at 1 and 2 years postoperatively.

Results:

Our study included 64 patients, with 32 patients in each treatment group. Operative time and fluoroscopy time were significantly higher in the Endo-TLIF vs. Mis-TLIF group, whereas estimated blood loss, postoperative drainage volume, and the low back pain visual analog scale (VAS) score at discharge were significantly lower. Both treatments achieved exact interbody fusion at final-follow up. There was no significant difference in the VAS score or Oswestry Disability Index between the groups at 1 and 2 years postoperatively. Complication rates were higher in the Endo-TLIF group (21.9%) than in the Mis-TLIF group (6.2%), although the difference was not significant.

Conclusions:

Although there was no difference in the long-term outcomes between the treatments, Endo-TLIF had less blood loss and a lower postoperative drainage volume and low back pain VAS score at discharge than Mis-TLIF. However, the longer operative time and potentially higher complication rate of Endo-TLIF suggest that surgeons may need to overcome the steeper learning curve than the procedure of Mis-TLIF.