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已发表论文
单节段 UBD-TLIF 与 MIS-TLIF 术后椎旁肌脂肪浸润及临床疗效的比较分析：一项基于磁共振成像的回顾性研究
Authors Yan J, Tian M, Wu M, Yuan Z, Fan Y, Wu X, Ni H , Zhao Y, Yu S, He S
Received 7 December 2024
Accepted for publication 29 September 2025
Published 30 October 2025 Volume 2025:18 Pages 5673—5680
DOI https://doi.org/10.2147/JPR.S507695
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Alaa Abd-Elsayed
Jiajun Yan,1,2,* Muhang Tian,1,2,* Min Wu,1,2,* Zhixin Yuan,1,2 Yunshan Fan,1,2 Xinbo Wu,1,2 Haijian Ni,1,2 Yingchuan Zhao,1,2 Shunzhi Yu,1,2 Shisheng He3
1Department of Orthopaedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, People’s Republic of China; 3Department of Orthopaedics, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shisheng He, Department of Orthopaedics, Shanghai East Hospital, School of Medicine, Tongji University, 150 Jimo Road, Shanghai, 20092, People’s Republic of China, Email tjhss7418@tongji.edu.cn Shunzhi Yu, Orthopedic Department, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, People’s Republic of China, Email maotoutou@163.com
Purpose: The paraspinal muscles, particularly the multifidus and erector spinae, are essential for supporting physiological loads, coordinating functional movements, and ensuring lumbar segment stability. This study aims to evaluate the effectiveness of Uni-Portal Bi-Channel Dual-Media Transforaminal Lumbar Interbody Fusion (UBD-TLIF) versus Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) in minimizing paraspinal muscle damage during lumbar surgeries.
Methods: This retrospective study analyzed patients who underwent single-level UBD-TLIF or MIS-TLIF from January 2020 to December 2022. Key outcomes measured included preoperative and postoperative Visual Analog Scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, radiological changes in paravertebral muscle integrity via MRI, operative time, estimated blood loss, and length of hospital stay.
Results: Among 103 patients (51 cases in UBD-TLIF group), no significant baseline differences were observed. Although UBD-TLIF takes longer operative time (210.80± 71.86 min vs 181.12± 36.74 min, P=0.002), UBD-TLIF group showed a significant less reduction in fat infiltration with a mean change of 7.29± 2.46 versus 10.51± 3.72 for MF (P< 0.001) and 4.63± 1.98 versus 7.62± 2.83 for ES (P< 0.001). Earlier recovery was noted in UBD-TLIF group, with Day 3 postoperative VAS scores for back pain significantly lower (2.12± 0.84) compared to MIS-TLIF (3.48± 1.08, P< 0.001), also shorter length of hospital stay (7.02± 1.75 vs 8.38± 1.33, P< 0.001). Additionally, UBD-TLIF group showed less estimated blood loss (155.69± 93.41mL vs 230.96± 102.18 mL, P< 0.001).
Conclusion: UBD-TLIF offers clinical outcomes comparable to MIS-TLIF for single-level lumbar interbody fusion surgery while providing enhanced muscle preservation and faster postoperative recovery. Additionally, the use of T2-weighted MRI and ImageJ software for measuring fat infiltration rates proves to be a reliable method.
Keywords: UBD-TLIF, MIS-TLIF, magnetic resonance imaging, fat infiltration, paraspinal muscle
1Department of Orthopaedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, People’s Republic of China; 3Department of Orthopaedics, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shisheng He, Department of Orthopaedics, Shanghai East Hospital, School of Medicine, Tongji University, 150 Jimo Road, Shanghai, 20092, People’s Republic of China, Email tjhss7418@tongji.edu.cn Shunzhi Yu, Orthopedic Department, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, People’s Republic of China, Email maotoutou@163.com
Purpose: The paraspinal muscles, particularly the multifidus and erector spinae, are essential for supporting physiological loads, coordinating functional movements, and ensuring lumbar segment stability. This study aims to evaluate the effectiveness of Uni-Portal Bi-Channel Dual-Media Transforaminal Lumbar Interbody Fusion (UBD-TLIF) versus Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) in minimizing paraspinal muscle damage during lumbar surgeries.
Methods: This retrospective study analyzed patients who underwent single-level UBD-TLIF or MIS-TLIF from January 2020 to December 2022. Key outcomes measured included preoperative and postoperative Visual Analog Scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, radiological changes in paravertebral muscle integrity via MRI, operative time, estimated blood loss, and length of hospital stay.
Results: Among 103 patients (51 cases in UBD-TLIF group), no significant baseline differences were observed. Although UBD-TLIF takes longer operative time (210.80± 71.86 min vs 181.12± 36.74 min, P=0.002), UBD-TLIF group showed a significant less reduction in fat infiltration with a mean change of 7.29± 2.46 versus 10.51± 3.72 for MF (P< 0.001) and 4.63± 1.98 versus 7.62± 2.83 for ES (P< 0.001). Earlier recovery was noted in UBD-TLIF group, with Day 3 postoperative VAS scores for back pain significantly lower (2.12± 0.84) compared to MIS-TLIF (3.48± 1.08, P< 0.001), also shorter length of hospital stay (7.02± 1.75 vs 8.38± 1.33, P< 0.001). Additionally, UBD-TLIF group showed less estimated blood loss (155.69± 93.41mL vs 230.96± 102.18 mL, P< 0.001).
Conclusion: UBD-TLIF offers clinical outcomes comparable to MIS-TLIF for single-level lumbar interbody fusion surgery while providing enhanced muscle preservation and faster postoperative recovery. Additionally, the use of T2-weighted MRI and ImageJ software for measuring fat infiltration rates proves to be a reliable method.
Keywords: UBD-TLIF, MIS-TLIF, magnetic resonance imaging, fat infiltration, paraspinal muscle