Abstract：Objective To compare the clinical effect and imaging results of bilateral decompression via a unilateral approach technique and transforaminal lumbar interbody fusion in the treatment of senile lumbar degenerative disc disease. Methods A total of 60 patients with senile lumbar degenerative disc disease who underwent surgery in the Department of Orthopaedics, Shantou Central Hospital from January 2017 to April 2020 were retrospectively selected as research objects. According to different surgical methods, they were divided into bilateral decompression via a unilateral approach (BDUA) group and transforaminal lumbar interbody fusion (TLIF) group, with 30 cases in each group. Operation-related complications, the operation time, intraoperative blood loss, drainage volume, hospital stay and other indicators were compared between the two groups. The preoperative and postoperative Japan Orthopedic Association(JOA), visual analogue scale (VAS) and Oswestry disability index (ODI) scores were compared between the two groups.The fusion rate at 3 months after operation was compared between the two groups. Results The intraoperative blood loss, postoperative drainage volume in the BUDA group were less than those in TLIF group, and VAS score at 3 months after operation in the BUDA group was lower than that in the TLIF group, the differences were statistically significant(P<0.05). There were no significant differences in JOA score and ODI score between the two groups before and after operation (P>0.05). There were no significant differences in fusion rate and lumbar lordosis between the two groups after operation (P>0.05). The fusion rate and lumbar lordosis at 6, 12 months after operation in the two groups were higher than those at 3 month after operation, the differences were statistically significant (P<0.05). Conclusion Bilateral decompression via a unilateral approach has more advantages in reducing intraoperative blood loss, postoperative drainage volume and early postoperative pain.
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