Comparison of clinical outcomes between biportal and uniportal full-endoscopy techniques in lumbar spinal stenosis with bilateral symptoms.

Abstract

Background: Uniportal full-endoscopy (UFE) technique has been continuously developed and applied for treating lumbar spinal stenosis. However, achieving effective decompression outcome of using the UFE technique remains technically demanding and uncertain. Previously, we have proposed the biportal full-endoscopy (BFE) technique to integrate the respective advantages of both UFE and unilateral biportal endoscopy technique. There is limited published data on the comparison of clinical outcomes between biportal and UFE techniques in lumbar spinal stenosis with bilateral symptoms.

Aim: To contrast the clinical outcomes between biportal and UFE techniques for treating lumbar spinal stenosis with bilateral symptoms.

Methods: This study retrospectively examined 100 patients diagnosed with lumbar spinal stenosis and bilateral symptoms. Among them, 52 cases were part of group A (BFE technique group), and 48 cases belonged to group B (UFE technique group). The visual analogue scale (VAS), Oswestry Disability Index (ODI), and modified Macnab criteria were used to evaluate the clinical outcomes.

Results: Group A had significantly shorter operation time than group B. Both groups experienced substantial relief in lower back and lower extremity pain on the severe side at postoperative 3 days, 3 months, and 12 months. Group A had notably lower VAS scores for mild side lower extremity pain at postoperative 3 months and 12 months compared to group B. Group A's ODI scores were significantly lower at postoperative 3 months and 12 months, whereas group B's scores did not significantly differ from preoperative values. Group A's ODI scores were significantly lower than group B's at postoperative 3 months and 12 months. Group A had a significantly higher excellent and good response rate (94.23%) compared to group B (81.25%) at postoperative 12 months based on the modified Macnab scale outcomes.

Conclusion: The BFE technique offers multiple benefits, including reduced trauma and quicker recovery as a minimally invasive surgery, and enhanced decompression efficiency over the UFE technique when treating lumbar spinal stenosis with bilateral symptoms.