Risk factors for perioperative complications following unilateral biportal endoscopic spine surgery.

Introduction: Unilateral biportal endoscopy (UBE) is a minimally invasive technique that has gradually gained popularity in the field of spine surgery.

Aim: The aim of this study was to identify independent risk factors associated with the occurrence of perioperative complications following UBE surgery through a comprehensive retrospective analysis.

Materials and methods: Consecutive patients who underwent UBE at the Department of Orthopedics of Beijing Friendship Hospital between June 2021 and July 2024 were retrospectively analyzed. Data on demographic characteristics, comorbidities, surgery‑related parameters, and perioperative complications were extracted from medical records, and patients who did and did not develop complications were compared. Potential risk factors for perioperative complications were evaluated using univariable and multivariable logistic regression analyses.

Results: In a cohort of 322 patients, perioperative complications were observed in 20 individuals, yielding an overall incidence rate of 6.8%. Occurrence of perioperative complications was associated with higher body mass index (BMI >28 kg/m2; P <0.001), diabetes mellitus (P <0.001), depression (P <0.001), preoperative analgesia (P = 0.03), American Society of Anesthesiologists classifiation (P <0.001), and longer operative time (>180 minutes; P <0.001). In the multivariable logistic regression analysis, surgery duration longer than 180 minutes (odds ratio [OR], 2.8; 95% CI, 1.5-5.4), depression (OR, 2.5; 95% CI, 1.3-4.7), and BMI greater than 28 kg/m2 (OR, 3.1; 95% CI, 1.7-5.9) were identified as independent risk factors for complications.

Conclusions: This study demonstrates that UBE surgery is an effective and safe minimally invasive technique for the management of lumbar degenerative diseases, with a relatively low complication rate of 6.8%. Longer operative time, preoperative depression, and a higher BMI were identified as independent risk factors for the occurrence of perioperative complications.