The purpose of this study was to compare the short-term clinical outcomes between extreme lateral interbody fusion (XLIF) and
minimally invasive surgery (MIS)-transforaminal interbody fusion (TLIF) in patients with degenerative
spondylolisthesis with
stenosis. One hundred-six patients were enrolled; 44 were treated with MIS-TLIF (direct
decompression group; DP), and 62 were treated with XLIF (indirect
decompression group;
IDP). Perioperative indexes included operation time and intraoperative
bleeding. Perioperative indexes preoperative and postoperative numeric rating scale (NRS) scores for
low back pain (NRS-BP), leg
pain (NRS-LP), and leg
numbness (NRS-LN), and the preoperative score on the Japanese version of the painDETECT questionnaire (
PDQ-J) were also assessed. The average follow-up period for the collection of NRS scores was 12.6 months. The operation time was significantly shorter in the
IDP than in the DP group (109.9 ± 35.4 vs. 153.3 ± 50.9 min; p < 0.001). Intraoperative blood loss was also significantly less in the
IDP group than in the DP group (85.4 ± 125.4 vs. 258.3 ± 220.4 mL; p < 0.001). The
PDQ-J score and preoperative NRS scores (NRS-BP, NRS-LP, and NRS-LN) did not differ significantly between groups. Less improvement in the NRS-BP (ΔNRS-BP) was observed in the DP group than in the
IDP group (p < 0.05). Although
pain improved after surgery in both groups,
IDP surgery was advantageous in minimizing
bleeding and preserving posterior support elements such as the facet joints, lamina, and paraspinal muscles. These findings suggest that this may have contributed to the higher rate of improvement in
low back pain compared with DP surgery.