Abstract:Objective To compare the surgical outcomes of percutaneous endoscopic visualized modified transforaminal lumbar interbody fusion（PEV-MTLIF）versus conventional open transforaminal lumbar interbody fusion（TLIF）in the treatment of grade Ⅰdegenerative lumbar spondylolisthesis（DLS）. Methods A retrospective analysis was performed on the clinical data of patients with single-level grade ⅠDLS who were treated in the Department of Spine Surgery，Xuzhou Central Hospital from June 2020 to December 2022. The patients were divided into a PEV-MTLIF group and an open TLIF group according to the surgical procedure. All patients were followed up for at least 1 year. Perioperative situation were evaluated by operative time，intraoperative blood loss，postoperative drainage，time to first ambulation，postoperative hospital stay，and incidence of surgical complications. Radiological outcomes were assessed by intervertebral disc height，lumbar spondylolisthesis percentage，slip angle，lumbar lordotic angle，and fusion rate.Clinical outcomes were evaluated using the Visual Analog Scale（VAS）scores for lumbocrural pain and the Oswestry Disability Index（ODI）. Results A total of 47 patients were included，with 22 in the PEV-MTLIF group and 25 in the open TLIF group. The PEV-MTLIF group had significantly less intraoperative blood loss，shorter time to first ambulation postoperatively，and shorter postoperative hospital stay compared with the open TLIF group ，with statistically significant differences（P<0.05）. There was no significant difference in the incidence of perioperative complications between the PEV-MTLIF group and the TLIF group（13.64% vs 8.00%，χ²=0.023，P=0.880）. Routine drainage was not placed in the PEV-MTLIF group；the postoperative drainage volume in the TLIF group was（259.60 ± 67.85）mL. The VAS scores and ODI showed significant inter - group，inter - time，and interaction effects （P<0.01）. At 1 month postoperatively，the PEV-MTLIF group had better VAS scores and ODI than the open TLIF group（P<0.05）. At 1 year postoperatively，there were no significant differences in VAS scores and ODI between the two groups（P>0.05）；both groups showed significant improvements in intervertebral disc height，lumbar spondylolisthesis percentage，slip angle，and lumbar lordotic angle compared with preoperative values（P<0.01），but no significant differences were found between the two groups for these parameters（P>0.05）. The fusion rate was 95.45%（21/22）in the PEV-MTLIF group and 96.00% （24/25）in the open TLIF group，with no significant difference between two groups （P=1.000）.Conclusion PEV-MTLIF is safe and effective for the treatment of grade ⅠDLS，and it is superior to conventional open TLIF in terms of perioperative clinical indicators and early rehabilitation.