Objective To explore the application effect of unilateral biportal endoscopy (UBE) versus percutaneous endoscopic lumbar discectomy (PELD) in lumbar fusion for patients with degenerative lumbar spondylolisthesis (DLS). Methods The clinical data of 94 DLS patients were retrospectively analyzed. According to the surgical method, they were divided into UBE group or PELD group, with 47 cases in each group. The perioperative related indicators (operation duration, intraoperative bleeding volume, number of intraoperative fluoroscopies, postoperative bed rest time, postoperative length of hospital stay), occurrence status of complications, bone graft fusion status, as well as the Visual Analogue Scale (VAS) scores for low back and leg pain, lumbar function (Oswestry disability index ［ODI］ score, Japanese Orthopaedic Association ［JOA］ score), lumbar morphology (sagittal Cobb angle, disc height ［DH］, vertebral slippage degree, slip angle), and quality of life (36⁃Item Short Form Health Survey ［SF⁃36］ score) before and after surgery were compared between the two groups. Results All patients in both groups achieved solid fusion criteria postoperatively. Compared with the UBE group, the PELD group exhibited a shorter operation duration, more intraoperative fluoroscopies, and more complications (P<0.05). The VAS scores for low back and leg pain and ODI scores in both groups depicted a decreasing trend over time after surgery, while the JOA scores interpreted an increasing trend (P<0.05). At 3 months and 6 months postoperatively, the VAS scores for low back and leg pain in the UBE group were lower than those in the PELD group (P<0.05), but there was no statistically significant difference in ODI and JOA scores between the two groups (P>0.05). At 6 months postoperatively, the sagittal Cobb angle, DH, and SF⁃36 scores in both groups increased compared to preoperative values, while vertebral slippage degree and slip angle decreased (P<0.05). However, there was no statistically significant difference in the above indicators between the two groups at 6 months postoperatively (P>0.05). Conclusion Both UBE and PELD applied in lumbar fusion for DLS patients can achieve good results, promoting the recovery of lumbar function and morphology. Although UBE increases the operation duration, it involves fewer intraoperative fluoroscopies and complications, provides more significant relief of low back and leg pain, and offers better decompression effects.

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