Is Full-endoscopic Transforaminal Lumbar Interbody Fusion superior to Open Transforaminal Lumbar Interbody Fusion for Single-level Degenerative Lumbar Spondylolisthesis? A Retrospective Study

Purpose: To evaluate the clinical efficacy and safety of full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) for treatment of single-level lumbar degenerative spondylolisthesis. 
Methods: Fifty-three patients were divided into 2 groups according to the surgical techniques: Endo-TLIF (n = 25) and TLIF (n = 28). Clinical efficacy was evaluated by pre- and post-operative. The operation time, operative blood loss, postoperative increased amount of serum creatine phosphohykinase (CPK), postoperative drainage volume, postoperative hospital stay time, total cost and operative complications were also recorded.
Results: Compared with TLIF group, Endo-TLIF group had similar intraoperative blood loss, less postoperative increased CPK, less postoperative drainage volume and shorter postoperative hospital stay but longer operative time and more total cost. The postoperative VAS back, leg scores and ODI scores were significantly improved compared with the preoperative scores in both two groups, and more significant improvement of postoperative VAS back scores and ODI scores were showed in Endo-TLIF group at one-month follow-up period (P < 0.05, respectively). No difference was found in intervertebral fusion rate between the two groups. 
Conclusion: Endo-TLIF indicates similar clinical effect compared with TLIF for the treatment of lumbar degenerative spondylolisthesis. And it has many surgical advantages such as less muscle trauma, less postoperative back pain, and fast functional recovery of the patient. However, steep learning curve, longer operative time and more total cost may be the disadvantages that limit this technique. And the Endo-TLIF treatment of patients with bilateral lateral recess stenosis is considered as a relative contraindication.
