Abstract: [Objective]To investigate the value of Wiltse approach transforaminal interbody fusion (Wiltse-TLIF) in the treatment of lumbar spinal stenosis compared with traditional approach.[Methods]A retrospective analysis was conducted on 40 patients with single-level lumbar spinal stenosis in our hospital from November 2021 to September 2022. Wiltse approach transforaminal lumbar fusion and posterior median approach transforaminal lumbar fusion (TLIF) were performed respectively. Operation time, total incision length, intraoperative blood loss, postoperative drainage volume, intraoperative fluoroscopy times, postoperative walking time, preoperative and postoperative VAS score and ODI score were compared. LMCSA (lean mutifidus cross sectional area) before surgery, 3 months and 6 months after surgery, Multifidus muscle MUP (motor unit potential) and denervation potential were compared before surgery and 1, 3 and 6 months after surgery.[Results]The operation was successfully completed in both groups. There was no statistical significance in the operation time, total incision length, intraoperative blood loss, postoperative drainage volume, intraoperative fluoroscopy times, preoperative VAS and ODI scores, preoperative LMCSA, preoperative MUP of multifidus muscle and ODI scores 1 month after surgery between the two groups (P>0.05). There were significant differences in postoperative walking time, postoperative LMCSA (3, 6 months),postoperative multifidus MUP and occurrence rate of denervation potential (1, 3, 6 months), postoperative VAS score (1 week and 1, 3, 6 months) and ODI score (3, 6 months) (P≤0.05).[Conclusion]The injury of multifidus muscle in Wiltse-TLIF group is lower than that in posterior median TLIF group, which can reduce pain and accelerate recovery, and is worthy of clinical promotion.