Lumbar interbody fusion stands as a preferred surgical solution for degenerative lumbar spine diseases. The procedure primarily aims to establish lumbar segment stability, directly addressing patient symptoms associated with spinal complications. Traditional open surgery, though effective, is linked with notable morbidities and extended recovery time. To mitigate these concerns, minimally invasive surgery (MIS) has garnered significant popularity, presenting an appealing alternative with numerous benefits such as reduced soft tissue trauma, decreased blood loss, and expedited recovery. Among MIS procedures, full endoscopic spinal surgery, characterized by its minimal invasiveness, holds the potential to further minimize morbidities while enhancing surgical outcomes. Endoscopic lumbar interbody fusion, a novel procedure within this paradigm, has gained attention for offering advantages comparable to those of minimally invasive transforaminal lumbar interbody fusion. However, the safety, efficacy, and associated surgical techniques and instrument design of this method continue to be subjects of ongoing debate. This paper critically reviews current evidence on the safety, efficacy, and advantages of endoscopic lumbar spinal interbody fusion, examining whether it could indeed supersede existing mainstream techniques.
Citations
Citations to this article as recorded by
Editorial: Beyond the Portal Wars—Forging a New Consensus in Endoscopic Spine Surgery Jin-Sung Kim, Piya Chavalparit Global Spine Journal.2026; 16(1): 9. CrossRef
Minimally Invasive Options for Spondylolisthesis Chibuikem A. Ikwuegbuenyi, Mousa Hamad, Ibrahim Hussain, Roger Härtl Neurosurgery Clinics of North America.2026; 37(1): 39. CrossRef
Trajectory and influencing factors of changes in anxiety and depression in elderly patients after lumbar interbody fusion Xiao-Feng Liu, Yan-Hua Wu, Guang-Xi Huang, Bin Yu, Hui-Juan Xu, Meng-Hua Qiu, Lin Kang World Journal of Psychiatry.2026;[Epub] CrossRef
Comparative Efficacy and Safety of Minimally Invasive, Full-Endoscopic, and Biportal Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Diseases: A Network Meta-Analysis Hsiao-Yi Cheng, Chun-Wei Liang, Yuan-Fu Liu, Chao-Jui Chang, Wei-Lun Chang, Ting-An Cheng, Hao-Chun Chuang, Yu-Chia Hsu, Cheng-Li Lin Global Spine Journal.2026; 16(4): 2040. CrossRef
Comparative Study on Effectiveness of Unilateral Biportal Endoscopic Lumbar Interbody Fusion and Percutaneous Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion in the Treatment of Lumbar Degenerative Diseases Wensen Pi, Yuxiang Deng, Yang Liu, Haidan Chen, Hongwei Zhao Clinical Spine Surgery.2026;[Epub] CrossRef
L5–S1 Anatomic Features Relevant to Minimally Invasive Decompression and Fusion: A Cadaveric and Imaging-Based Study Miguel Relvas-Silva, André Rodrigues Pinho, Vitorino Veludo, Daniel Medina-Dias, António Pereira Rodrigues, Hélio Alves, Maria Dulce Madeira, Pedro Alberto Pereira Diagnostics.2026; 16(4): 610. CrossRef
Endoscopic versus open lumbar decompression: a retrospective cohort study of 31,000 patients with 90-day follow-up Rohit Srinivas, Rohan Phadke, Samer Salman, Dana Hazem, Harlene Kaur, Rahul Kumar, Swapna Vaja, Nathan J. Lee Neurosurgical Review.2026;[Epub] CrossRef
A Review of Synthetic Bone Grafts in Lumbar Interbody Fusion Jaden Wise, Isabella Merem, Dahlia Wrubluski, Xuanzong Zhang, Ridge Weston, Min Shi, Maohua Lin, Frank D. Vrionis Bioengineering.2026; 13(3): 262. CrossRef
Letter to Editor Regarding “Comparative Efficacy and Safety of Minimally Invasive, Full-Endoscopic, and Biportal Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Diseases: A Network Meta-Analysis” by Cheng et al. Enrico Giordan, Jin-Sung Kim Global Spine Journal.2026;[Epub] CrossRef
Learning Curve for Biportal Endoscopic Transforaminal Lumbar Interbody Fusion in a Junior Endoscopic Spine Surgeon: A Phase-Specific Retrospective Analysis Tae Hoon Kang, Sang-Min Park, Byungjun Kang, Minjoon Cho, Jae Hyup Lee Clinics in Orthopedic Surgery.2026;[Epub] CrossRef
A retrospective case-control study: Comparison of the clinical efficacy of percutaneous transforaminal endoscopy-assisted lumbar fusion and traditional posterior decompression interbody fusion in the treatment of degenerative lumbar spinal stenosis Jie-Bin Huang, Yin-Feng Guo, Lei Pan, Wei-Xiong Chen, Bai-Yong Zhu, Yu Lei, Wei-Dong Jiao, Li-Bin Zheng, Cheng-Zhao Li, Hou-Jun Xue BMC Research Notes.2026;[Epub] CrossRef
Hidden and total perioperative blood loss in unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) versus endoscopic lumbar interbody fusion (Endo-LIF) for two-level degenerative lumbar disease: a retrospective cohort study Xiaoteng Feng, Bin Xie, Xiangyu Long, Yan Gong, Zhenghao Huang, Zhaojun Cheng, Fangling Zhong, Hao Liu, Chenxing Huang, Jiacheng Yang, Gengyang Shen, Yu Zhao, Hui Ren, Weibo Yu, Xiaobing Jiang, Binwei Chen European Journal of Medical Research.2026;[Epub] CrossRef
Minimally invasive spine surgery: current advantages, limitations, and future directions Weonmin Cho, Soo-Bin Lee, Seong Ho Oh, Young-Seo Park, Kyung-Yil Kang Asian Spine Journal.2026;[Epub] CrossRef
Robotic-Assisted Uniportal Full-Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Note on a Hybrid Form of Minimally Invasive Surgery Ting Yao Ang, A. Aravin Kumar, Chin Hong Ngai, John J.Y. Zhang, Jacob Y.L. Oh, Ji Min Ling, Thomas C.H. Tan Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 105. CrossRef
How many cases to proficiency? A systematic review of the learning curve in endoscopic lumbar interbody fusion Chinedu Egu, Hussein Akil, Thomas Clarke, Efeoghene Odjadjare, Neel Badhe, Gloria Etim, Jordana Blackwood, Khalid Salem, Nasir A. Quraishi, Elie Najjar European Spine Journal.2026;[Epub] CrossRef
The Correlation Analysis Between the Pedicle Screw Placement Palpation and Torque Dongping Wang, Jiamin Yang, Haishan Li, Wei Lin, Shenglin Lei, Yuxian Chen, Yawen You, Chang Liu, Yongxian Li, Yuewei Lin, Huizhi Guo, Guoye Mo, Yongchao Tang, Kai Yuan, Bin Mai, Zhen Zhang, Shuncong Zhang World Neurosurgery.2025; 194: 123439. CrossRef
Anterior Lumbar Interbody Fusion (ALIF) Versus Full-Endoscopic/Percutaneous TLIF With a Large-Footprint Interbody Cage: A Comparative Observational Study Christian Morgenstern, Francisco Nogueras, Geoffrey Delbos, Rudolf Morgenstern Global Spine Journal.2025; 15(6): 2910. CrossRef
Full-Percutaneous Trans-Kambin Lumbar Interbody Fusion With a Large-Footprint Interbody Cage Christian Morgenstern, Rudolf Morgenstern Global Spine Journal.2025; 15(7): 3101. CrossRef
Meta-Analysis of the Clinical Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion versus Endoscopic Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases Xiangxuan Li, Yiming Qu, Liang Zhou, Yanjie Zhou, Bin Peng, Jizeren Duo World Neurosurgery.2025; 195: 123662. CrossRef
The Role of Minimally Invasive Surgery in Spinal Trauma: A Review of Techniques, Outcomes, and Limitations Mounica R. Paturu, Joshua Woo, Brett Rocos, Peter Passias, Michael Haglund, Douglas Orndorff, C. Rory Goodwin, Kristen Jones, Khoi D. Than Neurosurgery.2025; 96(3S): S129. CrossRef
Classification of endoscopic spine procedures Mazda Farshad, Christoph J. Laux, Florian Wanivenhaus, José M. Spirig, Jonas Widmer, Michael Kelly, Javier Quillo-Olvera, Jin-Sung Kim, Facundo van Isseldyk, Sohrab Gollogly, James Yue, Xuexiao Ma, Vincent Hagel, Frédéric Cornaz North American Spine Society Journal (NASSJ).2025; 22: 100603. CrossRef
Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc Herniations Junseok Bae, Pratyush Shahi, Sang-Ho Lee, Han-Joong Keum, Ju-Wan Seok, Yong-Soo Choi, Jin-Sung Kim Neurospine.2025; 22(1): 118. CrossRef
A Cadaveric Comparison of Discectomy Performance During Transforaminal Lumbar Interbody Fusion Approach Using an Endoscopic Technique Versus a Minimally Invasive Tubular Approach Venakat Boddapati, Frank Yuk, Sohrab Virk Spine.2025; 50(10): 713. CrossRef
A systematic review of biportal endoscopic spinal surgery with interbody fusion Wongthawat Liawrungrueang, Ho-Jin Lee, Sang Bum Kim, Sang-Min Park, Watcharaporn Cholamjiak, Hyun-Jin Park Asian Spine Journal.2025; 19(2): 275. CrossRef
Effectiveness of biportal endoscopic lumbar interbody fusion using the multi-layer bone grafting technique: a retrospective study from Vietnam Tran Vu Hoang Duong, Pham Anh Tuan, Huynh Van Vu, Chu Van Lam, Le Tan Linh, Phan Duy, Wongthawat Liawrungrueang Asian Spine Journal.2025; 19(2): 228. CrossRef
Two-year follow-up of unilateral biportal endoscopy assisted extraforaminal lumbar interbody fusion: how to perform indirect decompression and fusion under endoscopy: a retrospective study in Japan Takaki Yoshimizu, Sanshiro Saito, Teruaki Miyake, Tetsutaro Mizuno, Ushio Nosaka, Keisuke Ishii, Mizuki Watanabe, Kanji Sasaki Asian Spine Journal.2025; 19(2): 217. CrossRef
Prolonged irrigation time in endoscopic aqueous medium impairs MSC/β-TCP adhesion and osteogenic potential Wugui Chen, Guangfeng Ling, Chengshou Lin, Hengmei Chen, Kongning Chen, Shijie Chen, Yuchao Ye, Chengzhao Liu Scientific Reports.2025;[Epub] CrossRef
Biportal Endoscopic Decompression for Degenerative Lumbar Spondylolisthesis With Stenosis Wongthawat Liawrungrueang, Ho-Jin Lee, Sang Bum Kim, Sang-Min Park, Hyun-Jin Park Neurospine.2025; 22(2): 556. CrossRef
The Surgical and Functional Outcomes of Biportal Posterolateral Endoscopic Lumbar Interbody Fusion via Percutaneous Pedicle Screw Incisional Wounds: A Case Series Yu-Hsiang Su, Chen-Yu Chen, Anh Tuan Bui, Giam Minh Trinh, Tsung-Jen Huang, Ching-Yu Lee, Meng-Huang Wu Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(Suppl 2): S235. CrossRef
Unilateral biportal endoscopy for minimally invasive spinal fusion: Advancements in biomaterials and clinical outcome optimization Song Fu, Li-Chuan Hou, Xiao-Ling Huang, Wei Zhao, Feng-Ming Wang, Ya-Nan Wang World Journal of Orthopedics.2025;[Epub] CrossRef
Early-stage lumbar paraspinal muscle injury: endoscopic versus transforaminal lumbar interbody fusion: a retrospective comparative analysis Wenbin Xuan, Qinghua Cheng, Yucheng Gao, Ziyi Song, Zengxin Gao Journal of Orthopaedic Surgery and Research.2025;[Epub] CrossRef
Comparison of clinical efficacy of two approaches for endoscopic lumbar fusion surgery in the treatment of single-segment lumbar spondylolisthesis Kun Li, Hang Lin, Zhibin Zhang, Xiangyu Meng Frontiers in Surgery.2025;[Epub] CrossRef
Comparative Clinical and Radiological Outcomes of Banana-Shaped Versus Straight Cages in Biportal Endoscopic Transforaminal Lumbar Interbody Fusion: A Retrospective Cohort Study Nguyen Ngoc Thoi, Nguyen Le Hoang Tuan, Le Tuong Vien, Nguyen Thanh Nhan, Hoang Nguyen Anh Tuan, Nguyen Van Thanh, Tran Nguyen Phuong, Bui Hong Thien Khanh Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(2): 172. CrossRef
Unilateral Biportal Endoscopy or Minimally Invasive Surgery for Transforaminal Lumbar Interbody Fusion? A Comparative Cohort Study Yansheng Huang, Zhen Chang, Sibo Wang, Baorong He World Neurosurgery.2025; 204: 124543. CrossRef
Unveiling Evolution: Exploring Endoscopic Interbody Fusion Surgery in Minimally Invasive Spine Surgery — Editorial for the January 2024 Special Issue of JMISST Keng-Chang Liu, Koichi Sairyo, Jwo-Luen Pao, Man Kyu Park Journal of Minimally Invasive Spine Surgery and Technique.2024; 9(Suppl 1): S1. CrossRef
Evolution, Current Trends, and Latest Advances of Endoscopic Spine Surgery Sharvari Gunjotikar, Malcolm Pestonji, Masato Tanaka, Tadashi Komatsubara, Shashank J. Ekade, Ahmed Majid Heydar, Huynh Kim Hieu Journal of Clinical Medicine.2024; 13(11): 3208. CrossRef
How to Prevent Nerve Root Injury in Uniportal Full Endoscopic Lumbar Fusion Surgery? Insights From a Cadaveric Anatomic Study With Simulation Surgery Yu-Chia Hsu, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Hyeun-Sung Kim, Cheng-Li Lin Spine.2024; 49(18): 1301. CrossRef
En bloc resection of the ligamentum flavum for bilateral decompression in unilateral biportal endoscopic transforaminal lumbar interbody fusion: a 2-year follow-up study Chao Li, Beiyu Xu, Yao Zhao, Longtao Qi, Lei Yue, Ranlyu Zhu, Chunde Li, Zhengrong Yu Journal of Orthopaedic Surgery and Research.2024;[Epub] CrossRef
Multiple Endoscopic Access Lumbar Interbody Fusion (MALIF): A New Technique for Unilateral Biportal Endoscopic Lumbar Interbody Fusion Using Monoportal Endoscopic Spine Surgery Techniques Shigeto Hiratsuka, Katsuyuki Sasaki, Nodoka Manabe, Takeshi Kaneko Cureus.2024;[Epub] CrossRef
Full-Endoscopic Resection of a Lumbar Intradural Tumor (Schwannoma): Video Case Report and Description of the Surgical Technique Vincent Hagel, Facundo Van Isseldyk Neurospine.2024; 21(4): 1096. CrossRef
Safety Profile of Biportal Endoscopic Spine Surgery Compared to Conventional Microscopic Approach: A Pooled Analysis of 2 Randomized Controlled Trials Sang-Min Park, Kwang-Sup Song, Dae-Woong Ham, Ho-Joong Kim, Min-Seok Kang, Ki-Han You, Choon Keun Park, Dong-Keun Lee, Jin-Sung Kim, Hong-Jae Lee, Hyun-Jin Park Neurospine.2024; 21(4): 1190. CrossRef
Reducing Postoperative Neurological Complications in Uniportal Full-Endoscopic Lumbar Interbody Fusion: Efficacy of the GUARD Technique Combined With Delayed Ligamentum Flavectomy Hao-Chun Chuang, Yu-Chia Hsu, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Hyeun Sung Kim, Cheng-Li Lin Neurospine.2024; 21(4): 1199. CrossRef
Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique Yu-Chia Hsu, Hao-Chun Chuang, Wei-Lun Chang, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Hyeun-Sung Kim, Cheng-Li Lin Neurospine.2024; 21(4): 1141. CrossRef
First
Prev
