{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:02:18Z","timestamp":1793037738923,"version":"4.5.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>As an emerging surgical technique, the potential advantages of unilateral biportal endoscopic transforaminal lumbar interbody fusion (ULIF) for lumbar spondylolisthesis have yet to be substantiated by robust evidence. This study aims to investigate effectiveness and security of ULIF compared to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in managing single-level lumbar spondylolisthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a comprehensive search in six databases for publications comparing ULIF with MIS-TLIF for lumbar spondylolisthesis, systematically reviewing literature up until July 19, 2025. Meta-analyses were carried out via Stata 17.0 software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve studies met our inclusion criteria. Compared with MIS-TLIF, ULIF demonstrated significantly reduced intraoperative blood loss [WMD\u202f=\u202f\u221235.71, 95% CI (\u221251.80, \u221219.63),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01], fewer intraoperative fluoroscopy times [WMD\u202f=\u202f\u22121.29, 95% CI (\u22122.56, \u22120.02),\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.05], lower postoperative drainage volume [WMD\u202f=\u202f\u221220.64, 95% CI (\u221237.13, \u22124.15),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.01], shorter postoperative ambulation time [WMD\u202f=\u202f\u22120.30, 95% CI (\u22120.42, \u22120.17),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01], and decreased hospital stay duration [WMD\u202f=\u202f\u22121.50, 95% CI (\u22122.09, \u22120.90),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01]. Additionally, patients undergoing ULIF exhibited improved visual analog scale scores for back pain [WMD\u202f=\u202f\u22120.09, 95% CI (\u22120.16, \u22120.02),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.01] and leg pain [WMD\u202f=\u202f\u22120.09, 95% CI (\u22120.16, \u22120.03),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.01] and Oswestry disability index [WMD\u202f=\u202f\u22120.77, 95% CI (\u22121.21, \u22120.32),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01] at final follow-up. Conversely, surgical duration for MIS-TLIF was significantly shorter than that for ULIF [WMD\u202f=\u202f18.63, 95% CI (9.39, 27.87),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01]. No significant differences were observed between both groups regarding disc height, lumbar lordosis, fusion rates, or complication rates (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In comparison to MIS-TLIF, ULIF presents several advantages including less intraoperative blood loss, reduced reliance on fluoroscopy, diminished postoperative drainage, earlier ambulation capabilities after surgery, shorter hospital stay as well as enhanced recovery from back and leg pain along with improved lumbar function in patients affected by lumbar spondylolisthesis. However, ULIF requires more operative time than MIS-TLIF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42025111069<\/jats:uri>\n                      , CRD420251110694.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1686492","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T06:29:20Z","timestamp":1763965760000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Unilateral biportal endoscopic transforaminal lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion for single-level lumbar spondylolisthesis: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Yu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jidong","family":"Ju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinchun","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1097\/BRS.0b013e31818edcfd","article-title":"Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population","volume":"34","author":"Kalichman","year":"2009","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e2000068","DOI":"10.2106\/JBJS.RVW.20.00068","article-title":"Pathomechanisms and predisposing factors for degenerative lumbar spondylolisthesis: a narrative review","volume":"8","author":"Yoshihara","year":"2020","journal-title":"JBJS Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1016\/j.spinee.2024.01.001","article-title":"Evolution of lumbar degenerative spondylolisthesis with key radiographic features","volume":"24","author":"Saremi","year":"2024","journal-title":"Spine J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1136\/bjsm.34.6.415","article-title":"Spondylolysis: a critical review","volume":"34","author":"Standaert","year":"2000","journal-title":"Br J Sports Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e079771","DOI":"10.1136\/bmj-2024-079771","article-title":"Decompression alone or with fusion for degenerative lumbar spondylolisthesis (Nordsten-DS): five year follow-up of a randomised, multicentre, non-inferiority trial","volume":"386","author":"Kgomotso","year":"2024","journal-title":"BMJ"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"100964","DOI":"10.1016\/j.lanepe.2024.100964","article-title":"Transforaminal versus posterior lumbar interbody fusion for symptomatic single-level spondylolisthesis (LIFT): a multicentre controlled, patient blinded, randomised non-inferiority trial","volume":"43","author":"Caelers","year":"2024","journal-title":"Lancet Reg Health Eur"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.1056\/NEJMoa070302","article-title":"Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis","volume":"356","author":"Weinstein","year":"2007","journal-title":"N Engl J Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1055\/s-2008-1051624","article-title":"A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion","volume":"120","author":"Harms","year":"1982","journal-title":"Z Orthop Ihre Grenzgeb"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14111112","article-title":"Correlation between Peripheric Blood markers and surgical invasiveness during humeral shaft fracture Osteosynthesis in young and middle-aged patients","volume":"14","author":"Moldovan","year":"2024","journal-title":"Diagnostics (Basel)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.spinee.2011.02.007","article-title":"Cranial facet joint violations by percutaneously placed pedicle screws adjacent to a minimally invasive lumbar spinal fusion","volume":"11","author":"Park","year":"2011","journal-title":"Spine J"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"E2","DOI":"10.3171\/2022.10.FOCUS22602","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the prospective multicenter quality outcomes database registry","volume":"54","author":"Chan","year":"2023","journal-title":"Neurosurg Focus"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1093\/neuros\/nyaa097","article-title":"A comparison of minimally invasive and open Transforaminal lumbar Interbody fusion for grade 1 degenerative lumbar spondylolisthesis: an analysis of the prospective quality outcomes database","volume":"87","author":"Chan","year":"2020","journal-title":"Neurosurgery"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1960","DOI":"10.1111\/os.13044","article-title":"Robot-assisted minimally invasive Transforaminal lumbar Interbody fusion in the treatment of lumbar spondylolisthesis","volume":"13","author":"Cui","year":"2021","journal-title":"Orthop Surg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1097\/BSD.0000000000000596","article-title":"Is minimally invasive Transforaminal Interbody fusion superior to traditional open technique?","volume":"31","author":"Wanderman","year":"2018","journal-title":"Clin Spine Surg"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"694","DOI":"10.31616\/asj.2020.0384","article-title":"Minimally invasive spine surgery: techniques, technologies, and indications","volume":"14","author":"Park","year":"2020","journal-title":"Asian Spine J"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"E328","DOI":"10.1097\/BRS.0000000000004136","article-title":"Ligamentum-preserved\/temporary preserved minimally invasive Transforaminal lumbar Interbody fusion for lumbar spondylolisthesis: technical note and 2-year follow-up","volume":"47","author":"Wang","year":"2022","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1622974","DOI":"10.3389\/fphar.2025.1622974","article-title":"Efficacy of platelet-rich plasma injection with percutaneous endoscopic lumbar discectomy for lumbar disc herniation: a systematic review and meta-analysis","volume":"16","author":"Zhang","year":"2025","journal-title":"Front Pharmacol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1186\/s13018-025-06034-1","article-title":"Clinical efficacy of unilateral biportal endoscopic technique for adjacent segment pathology following lumbar fusion","volume":"20","author":"Feng","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1533458","DOI":"10.3389\/fsurg.2025.1533458","article-title":"Unilateral biportal endoscopic lumbar interbody fusion vs. posterior lumbar interbody fusion for the treatment of bilateral lumbar spinal stenosis","volume":"12","author":"Dong","year":"2025","journal-title":"Front Surg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1186\/s12891-024-08046-0","article-title":"Unilateral biportal endoscopic lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion for single-segment lumbar degenerative disease: a meta-analysis","volume":"25","author":"He","year":"2024","journal-title":"BMC Musculoskelet Disord"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1186\/s13018-023-04138-0","article-title":"Short-term clinical efficacy and safety of unilateral biportal endoscopic transforaminal lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a systematic review and meta-analysis","volume":"18","author":"Han","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1186\/s13018-023-04393-1","article-title":"Comparing the efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion in lumbar degenerative diseases: a systematic review and meta-analysis","volume":"18","author":"Luan","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e34705","DOI":"10.1097\/MD.0000000000034705","article-title":"Comparison of efficacy between unilateral biportal endoscopic lumbar fusion versus minimally invasive transforaminal lumbar fusion in the treatment of lumbar degenerative diseases: a systematic review and meta-analysis","volume":"102","author":"Li","year":"2023","journal-title":"Medicine (Baltimore)"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.2147\/JPR.S472975","article-title":"Comparative evaluation of efficacy and complications between Biportal endoscopic lumbar Interbody fusion and minimally invasive Transforaminal lumbar Interbody fusion for lumbar degenerative diseases: a systematic review and Meta-analysis","volume":"18","author":"Hu","year":"2025","journal-title":"J Pain Res"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane collaboration's tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur J Epidemiol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"229","DOI":"10.2147\/ORR.S336479","article-title":"Unilateral Biportal endoscopic lumbar Interbody fusion: a technical note and an outcome comparison with the conventional minimally invasive fusion","volume":"13","author":"Gatam","year":"2021","journal-title":"Orthop Res Rev"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"E64","DOI":"10.1097\/BSD.0000000000001024","article-title":"Comparison of minimal invasive versus Biportal endoscopic Transforaminal lumbar Interbody fusion for single-level lumbar disease","volume":"34","author":"Kim","year":"2021","journal-title":"Clinical Spine Surgery"},{"key":"ref30","first-page":"814","article-title":"Preliminary study of unilateral biportal endoscopic lumbar interbody fusion for the treatment of grade I lumbar spondylolisthesis","volume":"22","author":"Song","year":"2022","journal-title":"Chin J Min Invasive Surg"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1186\/s13018-023-04401-4","article-title":"Clinical comparison of unilateral biportal endoscopic transforaminal lumbar interbody fusion verse 3D microscope-assisted transforaminal lumbar interbody fusion in the treatment of single-segment lumbar spondylolisthesis with lumbar spinal stenosis: a retrospective study with 24-month follow-up","volume":"18","author":"Guo","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"52","DOI":"10.7507\/1002-1892.202210017","article-title":"Comparison of mid-term effectiveness of unilateral biportal endoscopy-transforaminal lumbar interbody fusion with minimally invasive surgery-transforaminal lumbar interbody fusion assisted with three-dimensional microscope in treating lumbar spondylolisthesis","volume":"37","author":"Yu","year":"2023","journal-title":"Chinese J Rep Reconstruct Surg"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-024-05315-5","article-title":"Comparative efficacy and fusion outcomes of unilateral bi-portal endoscopic transforaminal lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion in treating single-segment degenerative lumbar spondylolisthesis with lumbar spinal stenosis: a two-year retrospective study","volume":"19","author":"Bahir","year":"2024","journal-title":"J Orthop Surg Res"},{"key":"ref34","first-page":"2221","article-title":"UBE-TLIF versus MIS-TLIF for mild to moderate lumbar spondylolisthesis","volume":"32","author":"Feng","year":"2024","journal-title":"Orthop J China"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1186\/s12893-024-02651-5","article-title":"Comparison of results among UBE-TLIF, MIS-TLIF and open TLIF for Meyerding grade I lumbar spondylolisthesis: a retrospective study","volume":"24","author":"Lu","year":"2024","journal-title":"BMC Surg"},{"key":"ref36","first-page":"181","article-title":"Comparison of two kinds of transforaminal lumbar interbody fusion for treatment of lumbar spondylolisthesis","volume":"27","author":"Pan","year":"2024","journal-title":"J Clinic Orthopaedics"},{"key":"ref37","first-page":"1564","article-title":"Endoscopic lumbar fusion versus counterpart with tubular retractors for lumbar spondylolisthesis","volume":"32","author":"Sang","year":"2024","journal-title":"Orthop J China"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1186\/s12891-025-08892-6","article-title":"Comparison of short-term effectiveness between unilateral biportal endoscopic and MED-assisted transforaminal lumbar interbody fusion for mild single-segment lumbar spondylolisthesis","volume":"26","author":"He","year":"2025","journal-title":"BMC Musculoskelet Disord"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1186\/s12891-025-08777-8","article-title":"Unilateral biportal endoscopic lumbar interbody fusion (ULIF) versus minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for the treatment of degenerative lumbar spondylolisthesis: a retrospective analysis","volume":"26","author":"Zhu","year":"2025","journal-title":"BMC Musculoskelet Disord"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"143s","DOI":"10.1177\/2192568219882344","article-title":"Comparison of minimally invasive versus open transforaminal interbody lumbar fusion","volume":"10","author":"Kim","year":"2020","journal-title":"Glob Spine J"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"8815432","DOI":"10.1155\/2020\/8815432","article-title":"Learning curve and clinical outcome of Biportal endoscopic-assisted lumbar Interbody fusion","volume":"2020","author":"Kim","year":"2020","journal-title":"Biomed Res Int"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.2147\/JPR.S371635","article-title":"Comparison between PE-TLIF and MIS-TLIF in the treatment of middle-aged and elderly patients with single-level lumbar disc herniation","volume":"15","author":"Han","year":"2022","journal-title":"J Pain Res"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1186\/s12891-023-06374-1","article-title":"Comparison of surgical invasiveness, hidden blood loss, and clinical outcome between unilateral biportal endoscopic and minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative disease: a retrospective cohort study","volume":"24","author":"Huang","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"e1047","DOI":"10.1016\/j.wneu.2023.11.034","article-title":"Exposure of the cavernous sinus via the endoscopic Transorbital and endoscopic Endonasal approaches: a comparative study","volume":"181","author":"Wang","year":"2024","journal-title":"World Neurosurg"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.wneu.2022.01.071","article-title":"Evaluation of the outcomes of Biportal endoscopic lumbar Interbody fusion compared with conventional fusion operations: a systematic review and Meta-analysis","volume":"160","author":"Lin","year":"2022","journal-title":"World Neurosurg"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"2066","DOI":"10.1016\/j.spinee.2021.06.013","article-title":"Minimally invasive transforaminal lumbar interbody fusion using the biportal endoscopic techniques versus microscopic tubular technique","volume":"21","author":"Kang","year":"2021","journal-title":"Spine J"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.wneu.2019.02.038","article-title":"A systematic review of unilateral Biportal endoscopic spinal surgery: preliminary clinical results and complications","volume":"125","author":"Lin","year":"2019","journal-title":"World Neurosurg"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1686492\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T06:29:23Z","timestamp":1763965763000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1686492\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":47,"alternative-id":["10.3389\/fmed.2025.1686492"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1686492","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,24]]},"article-number":"1686492"}}