Objective:

In recent years, biportal endoscopic lumbar interbody fusion (BE-LIF) has been increasingly employed in the treatment of lumbar degenerative diseases. BE-LIF combines the benefits of minimally invasive fusion with endoscopic spine surgery. However, there is little evidence on whether BE-LIF is superior to posterolateral lumbar interbody fusion. The purpose of this meta-analysis is to compare the clinical outcomes, complications, and fusion rates of BE-LIF and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF)/posterior lumbar interbody fusion (PLIF) in treating lumbar degenerative diseases.

Methods:

A comprehensive assessment of the literature was conducted, and the quality of the retrieved studies was evaluated using the Newcastle-Ottawa Scale. Clinical parameters were investigated using the Visual Analog Scale (VAS) for pain levels and the Oswestry Disability Index (ODI) for disability levels. The operative times, estimated blood loss, fusion rates, and complications were also analyzed.

Results:

This meta-analysis comprised five studies with a total of 444 participants. No significant differences between the techniques were seen in VAS scores for legs, ODI scores, complications, or fusion rates. Notably, there were significantly lower VAS scores for back pain in the BE-LIF group than the MI-TLIF/PLIF group, postoperatively. In addition, BE-LIF resulted in significantly less blood loss but required a longer operative time than MI-TLIF/PLIF.

Conclusion:

The benefits of BE-LIF and MI-TLIF/PLIF were roughly equivalent in terms of clinical outcomes and achievement of fusion, and complication rates were similar in both groups. However, BE-LIF reduced postoperative back pain and blood loss, despite longer operative times.