Two-year follow-up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion: how to perform indirect decompression and fusion under endoscopy: a retrospective study in Japan

Study Design Retrospective study. Purpose To compare the clinical and radiographic outcomes of unilateral biportal endoscopy-assisted extraforaminal lumbar interbody fusion (BE-ELIF) and oblique lateral interbody fusion (OLIF). Overview of Literature OLIF is widely recognized for its strong realignm...

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Main Authors: Takaki Yoshimizu, Sanshiro Saito, Teruaki Miyake, Tetsutaro Mizuno, Ushio Nosaka, Keisuke Ishii, Mizuki Watanabe, Kanji Sasaki
Format: Article
Language:English
Published: Korean Spine Society 2025-04-01
Series:Asian Spine Journal
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Online Access:http://asianspinejournal.org/upload/pdf/asj-2025-0071.pdf
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author Takaki Yoshimizu
Sanshiro Saito
Teruaki Miyake
Tetsutaro Mizuno
Ushio Nosaka
Keisuke Ishii
Mizuki Watanabe
Kanji Sasaki
author_facet Takaki Yoshimizu
Sanshiro Saito
Teruaki Miyake
Tetsutaro Mizuno
Ushio Nosaka
Keisuke Ishii
Mizuki Watanabe
Kanji Sasaki
author_sort Takaki Yoshimizu
collection DOAJ
description Study Design Retrospective study. Purpose To compare the clinical and radiographic outcomes of unilateral biportal endoscopy-assisted extraforaminal lumbar interbody fusion (BE-ELIF) and oblique lateral interbody fusion (OLIF). Overview of Literature OLIF is widely recognized for its strong realignment capability, achieved through placing a large interbody cage, and its favorable clinical outcomes with indirect decompression. ELIF, similar to OLIF, does not entail exposure of the spinal canal. At our hospital, BE-ELIF involves removing the superior articular processes on both sides, inserting two expandable cages, and performing indirect canal decompression. BE-ELIF is a lumbar interbody fusion technique that provides indirect decompression similar to OLIF. However, no studies have compared the efficacy of ELIF performed under unilateral biportal endoscopy with that of OLIF. Methods Forty-nine adults who underwent single-level L4/5 interbody fusion for degenerative spondylolisthesis were divided into BE-ELIF (n=27) and OLIF (n=22) groups based on the surgical approach used. Clinical outcomes were assessed using the Visual Analog Scale and the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Radiographic parameters, including distance of spondylolisthesis, disc height, segmental lordosis, lumbar lordosis, pelvic tilt, and sagittal vertical axis, were evaluated preoperatively and at final follow-up. Results OLIF provided significantly better relief of pain in lower limbs and buttocks at 1-year follow-up. No significant between-group differences were observed in JOABPEQ domains. BE-ELIF resulted in greater improvements in spondylolisthesis distance and disc height, while other parameters did not differ significantly between the two groups. Conclusions For L4/5 degenerative spondylolisthesis, BE-ELIF demonstrated superior spondylolisthesis reduction and disc height improvement than OLIF. Although BE-ELIF was associated with some inferior clinical outcomes, it provided satisfactory results, effective realignment, and a low complication risk.
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spelling doaj-art-63e62311a3b2479a897b7fa01bedb6f82025-08-20T01:52:10ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462025-04-0119221722710.31616/asj.2025.00711742Two-year follow-up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion: how to perform indirect decompression and fusion under endoscopy: a retrospective study in JapanTakaki Yoshimizu0Sanshiro Saito1Teruaki Miyake2Tetsutaro Mizuno3Ushio Nosaka4Keisuke Ishii5Mizuki Watanabe6Kanji Sasaki7 Department of Orthopaedic Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan Department of Spine and Bone Tumor, Seirei Hamamatsu General Hospital, Hamamatsu, Japan Department of Spine and Bone Tumor, Seirei Hamamatsu General Hospital, Hamamatsu, Japan Department of Spine and Bone Tumor, Seirei Hamamatsu General Hospital, Hamamatsu, Japan Department of Spine and Bone Tumor, Seirei Hamamatsu General Hospital, Hamamatsu, Japan Department of Spine and Bone Tumor, Seirei Hamamatsu General Hospital, Hamamatsu, Japan Department of Spine and Bone Tumor, Seirei Hamamatsu General Hospital, Hamamatsu, Japan Department of Orthopaedic Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, JapanStudy Design Retrospective study. Purpose To compare the clinical and radiographic outcomes of unilateral biportal endoscopy-assisted extraforaminal lumbar interbody fusion (BE-ELIF) and oblique lateral interbody fusion (OLIF). Overview of Literature OLIF is widely recognized for its strong realignment capability, achieved through placing a large interbody cage, and its favorable clinical outcomes with indirect decompression. ELIF, similar to OLIF, does not entail exposure of the spinal canal. At our hospital, BE-ELIF involves removing the superior articular processes on both sides, inserting two expandable cages, and performing indirect canal decompression. BE-ELIF is a lumbar interbody fusion technique that provides indirect decompression similar to OLIF. However, no studies have compared the efficacy of ELIF performed under unilateral biportal endoscopy with that of OLIF. Methods Forty-nine adults who underwent single-level L4/5 interbody fusion for degenerative spondylolisthesis were divided into BE-ELIF (n=27) and OLIF (n=22) groups based on the surgical approach used. Clinical outcomes were assessed using the Visual Analog Scale and the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Radiographic parameters, including distance of spondylolisthesis, disc height, segmental lordosis, lumbar lordosis, pelvic tilt, and sagittal vertical axis, were evaluated preoperatively and at final follow-up. Results OLIF provided significantly better relief of pain in lower limbs and buttocks at 1-year follow-up. No significant between-group differences were observed in JOABPEQ domains. BE-ELIF resulted in greater improvements in spondylolisthesis distance and disc height, while other parameters did not differ significantly between the two groups. Conclusions For L4/5 degenerative spondylolisthesis, BE-ELIF demonstrated superior spondylolisthesis reduction and disc height improvement than OLIF. Although BE-ELIF was associated with some inferior clinical outcomes, it provided satisfactory results, effective realignment, and a low complication risk.http://asianspinejournal.org/upload/pdf/asj-2025-0071.pdflumbosacral regionspondylolisthesisunilateral biportal endoscopic spine surgeryextraforaminal lumbar interbody fusionindirect decompression
spellingShingle Takaki Yoshimizu
Sanshiro Saito
Teruaki Miyake
Tetsutaro Mizuno
Ushio Nosaka
Keisuke Ishii
Mizuki Watanabe
Kanji Sasaki
Two-year follow-up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion: how to perform indirect decompression and fusion under endoscopy: a retrospective study in Japan
Asian Spine Journal
lumbosacral region
spondylolisthesis
unilateral biportal endoscopic spine surgery
extraforaminal lumbar interbody fusion
indirect decompression
title Two-year follow-up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion: how to perform indirect decompression and fusion under endoscopy: a retrospective study in Japan
title_full Two-year follow-up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion: how to perform indirect decompression and fusion under endoscopy: a retrospective study in Japan
title_fullStr Two-year follow-up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion: how to perform indirect decompression and fusion under endoscopy: a retrospective study in Japan
title_full_unstemmed Two-year follow-up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion: how to perform indirect decompression and fusion under endoscopy: a retrospective study in Japan
title_short Two-year follow-up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion: how to perform indirect decompression and fusion under endoscopy: a retrospective study in Japan
title_sort two year follow up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion how to perform indirect decompression and fusion under endoscopy a retrospective study in japan
topic lumbosacral region
spondylolisthesis
unilateral biportal endoscopic spine surgery
extraforaminal lumbar interbody fusion
indirect decompression
url http://asianspinejournal.org/upload/pdf/asj-2025-0071.pdf
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