Neurosurgical Review

, Volume 42, Issue 3, pp 753–761 | Cite as

Clinical and radiological outcomes of unilateral biportal endoscopic lumbar interbody fusion (ULIF) compared with conventional posterior lumbar interbody fusion (PLIF): 1-year follow-up

  • Man-Kyu Park
  • Soo-An ParkEmail author
  • Sang-Kyu Son
  • Weon-Wook Park
  • Seung-Hyun Choi
Original Article


This study retrospectively compared clinical and radiological outcomes of unilateral biportal endoscopic lumbar interbody fusion (ULIF) to those of conventional posterior lumbar interbody fusion (PLIF). Seventy-one ULIF (age, 68 ± 8 years) and 70 PLIF (66 ± 9 years) patients for one lumbosacral segment followed more than 1 year were selected. Parameters for surgical techniques (operation time, whether transfused), clinical results [visual analogue scale (VAS) for back and leg pain, Oswestry disability index (ODI)], surgical complications (dural tear, nerve root injury, infection), and radiological results (cage subsidence, screw loosening, fusion) between the two groups were compared. The PLIF group demonstrated a significantly shorter operation time and more transfusions done than the ULIF group. The VAS for leg pain in both groups and for back pain in the ULIF group significantly improved at 1 week, while the VAS for back pain in the PLIF group significantly improved at 1 year. ODI scores improved at 1 year in both groups. Complication rates were not significantly different between groups. Fusion rates with definite and probable grades were not significantly different between groups. However, the ULIF group had significantly (P = 0.013) fewer cases of definite fusion and more cases of probable fusion [43 (74.1%) and 15 (25.9%) cases, respectively] than the PLIF group [58 (92.1%) and 5 (7.9%) cases, respectively]. ULIF is less invasive while just as effective as conventional PLIF in improving clinical outcomes and obtaining fusion. However, ULIF has a longer operation time than PLIF and requires further development to improve the fusion grade.


Unilateral biportal endoscopic lumbar interbody fusion Posterior lumbar interbody fusion Clinical outcome Radiological outcome 



No funding was received for this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval was obtained from the Institutional Ethics Committee of the Ministry of Health and Welfare in South Korea (P01-201810-21-006).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Online resource 1

ULIF procedures resecting facet joint and exposing the ipsilateral disc surface (WMV 12427 kb)

Online resource 2

Endplate preparation in ULIF procedures (WMV 13896 kb)

10143_2019_1114_MOESM3_ESM.wmv (10.5 mb)
Online resource 3 Cage inserting procedure while protecting thecal sac in ULIF procedures (WMV 10740 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019
corrected publication 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryParkweonwook HospitalBusanSouth Korea
  2. 2.Department of Orthopaedic SurgeryParkweonwook HospitalBusanSouth Korea
  3. 3.Department of Orthopaedic SurgeryChung General HospitalSeongnam-siSouth Korea

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