Comparison of biportal endoscopic vs minimally invasive transforaminal lumbar interbody fusion for single-level low-grade lumbar spondylolisthesis: A retrospective cohort study

doi:10.5312/wjo.124542

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Orthop. Oct 18, 2026; 17(10): 124542
Published online Oct 18, 2026. doi: 10.5312/wjo.124542

Table 1 Demographics and operative data, n (%)/mean ± SD

Variable	BE-TLIF (n = 32)	MI-TLIF (n = 31)	t/χ²	P value
Sex (male/female)	14/18	12/19	0.026	0.872
Age (year)	51.95 ± 9.20	54.29 ± 12.59	-0.758	0.451
BMI (kg/m²)	23.87 ± 1.92	23.81 ± 2.02	0.12	0.905
Course of disease (months)	12.30 ± 3.22	13.10 ± 2.68	1.07	0.289
Smoking (yes/no)	16/16	15/16	0.016	0.900
Level
L3/4	3 (9.4)	5 (16.1)		0.769¹
L4/5	23 (71.9)	20 (64.5)
L5/S1	6 (18.8)	6 (19.4)
Spondylolisthesis type
Degenerative	24 (75.0)	25 (80.6)	0.440	0.507
Isthmic	8 (25.0)	6 (19.4)	0.440	0.507
Meyerding grade
I	26 (81.3)	24 (77.4)	0.152	0.697
II	6 (18.8)	7 (22.6)	0.152	0.697

¹Fisher-Freeman-Halton exact test for overall distribution of levels.

BMI: Body mass index; BE-TLIF: Biportal endoscopic transforaminal lumbar interbody fusion; MI-TLIF: Minimally invasive transforaminal lumbar interbody fusion.

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Table 2 Comparison of perioperative parameters and complications, n (%)/mean ± SD

Variable	BE-TLIF (n = 32)	MI-TLIF (n = 31)	MD/RD (95%CI)	t/χ²	P value
Operation time (minute)	189.36 ± 20.94	150.35 ± 21.16	39.01 (28.40 to 9.62)	6.65	< 0.001
Hospital stay (days)	5.14 ± 1.28	6.19 ± 1.33	-1.05 (-1.71 to 0.39)	-2.93	< 0.005¹
Preop Hb (g/L)	136.77 ± 12.59	138.10 ± 11.24	-1.33 (-7.34 to 4.68)	-0.41	0.681
Postop 24 hours Hb (g/L)	126.23 ± 13.50	125.84 ± 14.57	0.39 (-6.69 to 7.47)	0.10	0.919
Preop CRP (mg/L)	5.68 ± 2.34	6.03 ± 2.71	-0.35 (-1.63 to 0.93)	-0.50	0.621
Postop 24 hours CRP (mg/L)	20.90 ± 6.03	21.00 ± 6.15	-0.10 (-3.17 to 2.97)	-0.06	0.949
Preop CK (IU/L)	82.34 ± 35.74	84.26 ± 34.36	-1.92 (-19.58 to 15.74)	-0.20	0.844
Postop 24 hours CK (IU/L)	251.21 ± 29.48	316.52 ± 33.37	-65.31(-81.20 to -49.42)	-7.35	< 0.001
Complications	2 (6.3)	3 (9.7)	-3.4% (-16.8% to 9.9%)		0.672
Dural tear	1	2			0.610
Numbness	1	1			1.000

¹Fisher’s exact test.

BE-TLIF: Biportal endoscopic transforaminal lumbar interbody fusion; MI-TLIF: Minimally invasive transforaminal lumbar interbody fusion; Hb: Hemoglobin; CK: Creatine kinase; CRP: C-reactive protein.

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Table 3 Comparison of clinical outcomes, n (%)/mean ± SD

Variable	BE-TLIF (n = 32)	MI-TLIF (n = 31)	MD/RD (95%CI)	Group × time interaction
VAS				F = 3.82, P = 0.007
Preoperative	7.86 ± 1.08	7.45 ± 1.03	0.41 (-0.17 to 0.99)
Postoperative 3 days	3.65 ± 0.78	4.32 ± 0.69	-0.67 (-1.08 to -0.26)	P = 0.005²
Postoperative 3 months	3.48 ± 0.51	3.64 ± 0.49	-0.16 (-0.43 to 0.11)
Postoperative 12 months	1.95 ± 0.84	2.06 ± 0.81	-0.11 (-0.57 to 0.35)
Final follow-up	0.91 ± 0.82	0.86 ± 0.80	0.05 (-0.40 to 0.50)
ODI				F = 0.52, P = 0.721
Preoperative	69.68 ± 5.65	71.48 ± 5.49	-1.80 (-5.49 to 1.89)
Postoperative 3 months	24.09 ± 2.78	24.23 ± 2.63	-0.14 (-1.56 to 1.28)
Postoperative 12 months	22.18 ± 4.91	21.84 ± 4.08	0.34 (-2.07 to 2.75)
Final follow-up	14.91 ± 3.22	15.77 ± 3.02	-0.86 (-2.42 to 0.70)
MCID achievement	25 (78.1)	23 (74.2)	3.9 (-17.1 to 24.9)	P = 0.724¹

¹Bonferroni-corrected P values (adjusted significance threshold α = 0.01).

²Fisher’s exact test.

VAS: Visual analogue scale; ODI: Oswestry Disability Index; MD: Mean difference; RD: Risk difference; BE-TLIF: Biportal endoscopic transforaminal lumbar interbody fusion; MI-TLIF: Minimally invasive transforaminal lumbar interbody fusion.

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Table 4 Radiological parameters, n (%)/mean ± SD

Variable	BE-TLIF (n = 32)	MI-TLIF (n = 31)	MD/RD 95%CI	Group × time interaction
DH (mm)				F = 0.58, P = 0.630
Preoperative	9.06 ± 0.78	8.86 ± 0.54	0.20 (-0.21 to 0.61)
Postoperative 3 months	10.33 ± 0.67	10.60 ± 0.56	-0.27 (-0.61 to 0.07)
Postoperative 12 months	10.35 ± 0.68	10.62 ± 0.63	-0.27 (-0.62 to 0.08)
Final follow-up	10.40 ± 0.60	10.62 ± 0.58	-0.22 (-0.54 to 0.10)
LL (°)				F = 0.45, P = 0.718
Preoperative	31.31 ± 0.61	31.15 ± 0.58	0.16 (-0.21 to 0.53)
Postoperative 3 months	32.04 ± 0.55	31.92 ± 0.52	0.12 (-0.20 to 0.44)
Postoperative 12 months	34.00 ± 0.49	34.14 ± 0.59	-0.14 (-0.38 to 0.10)
Final follow-up	33.89 ± 0.53	33.95 ± 0.54	-0.06 (-0.28 to 0.16)
SLA (°)				F = 0.21, P = 0.889
Preoperative	9.49 ± 1.12	9.76 ± 1.11	-0.27 (-0.84 to 0.30)
Postoperative 3 months	11.65 ± 0.90	11.49 ± 0.95	0.16 (-0.31 to 0.63)
Postoperative 12 months	11.88 ± 0.62	11.92 ± 0.59	-0.04 (-0.29 to 0.21)
Final follow-up	11.63 ± 0.74	11.68 ± 0.82	-0.05 (-0.39 to 0.29)
SP (%)				F = 0.36, P = 0.782
Preoperative	17.65 ± 3.70	18.59 ± 4.33	-0.94 (-3.42 to 1.54)
Postoperative 3 months	3.42 ± 1.12	3.62 ± 1.44	-0.20 (-0.92 to 0.52)
Postoperative 12 months	3.59 ± 0.71	3.70 ± 1.06	-0.11 (-0.51 to 0.29)
Final follow-up	3.66 ± 0.77	3.74 ± 0.97	-0.08 (-0.44 to 0.28)
FR (%)	29 (90.6)	28 (90.3)	0.3 (-14.2 to 14.8)	P = 0.979¹

¹Fisher’s exact test.

DH: Disc height; LL: Lumbar lordosis; SLA: Segmental lordosis angle; SP: Slip percentage; FR: Fusion rate; MD: Mean difference; RD: Risk difference; BE-TLIF: Biportal endoscopic transforaminal lumbar interbody fusion; MI-TLIF: Minimally invasive transforaminal lumbar interbody fusion.

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Citation: He P, Sun J, Liu XW, Gao Q, Xu B, Cong Y, Zhao WL. Comparison of biportal endoscopic vs minimally invasive transforaminal lumbar interbody fusion for single-level low-grade lumbar spondylolisthesis: A retrospective cohort study. World J Orthop 2026; 17(10): 124542
URL: https://www.wjgnet.com/2218-5836/full/v17/i10/124542.htm
DOI: https://dx.doi.org/10.5312/wjo.124542

He P, Sun J, Liu XW, Gao Q, Xu B, Cong Y, Zhao WL. Comparison of biportal endoscopic vs minimally invasive transforaminal lumbar interbody fusion for single-level low-grade lumbar spondylolisthesis: A retrospective cohort study. World J Orthop 2026; 17(10): 124542 [DOI: 10.5312/wjo.124542]

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