To assess the clinical effectiveness of unilateral biportal endoscopy (UBE)  and  uniportal endoscopy (UE) in the management of lumbar spinal stenosis.

Abstract

Purpose To assess the clinical effectiveness of unilateral biportal endoscopy (UBE) and uniportal endoscopy (UE) in the management of lumbar spinal stenosis. Methods Retrospective analysis was done on the clinical records of 61 patients with lumbar spinal stenosis treated with UBE or UE in the minimally invasive spine surgery department of the Sixth Affiliated Hospital of Xinjiang Medical University between January 2023 and January 2024. The patients' average age was 66.4±12.5, and they included 24 males and 37 females. Using various surgical techniques, the patients were split into two groups: the UE group (33 cases) and the UBE group (28 cases). In order to assess the treatment scores, data on the two groups' operational times, intraoperative blood loss, visual analogue scales (VAS), and 0swestry Disability Index (0DI) were gathered and compared. The area of the dural sac and the angle of facet joint resection were determined based on preoperative and postoperative MRI and CT scans, and the problems were noted. Results Every patient had a successful surgical procedure.The intraoperative blood loss in the UBE group was 79.8±17.2ml, and the operative time was 68.7±9.8min.The group's UE was 71.5±10.8min and 73.5±21.7ml, respectively. There was no statistically significant difference between the groups (p>0.05).The two groups' post-operative VAS and ODI scores were lower than their pre-operative scores and exhibited a persistent downward trend. No statistically significant differences were found between the groups (p>0.05) in the variance analysis of the repeated measurement design.At the most recent follow-up, the rate of good and good showed no statistical significance (P>0.05).The dural sac area was (103.25±35.16) mm2 in the UE group and (126.73±42.74) mm2 in the UBE group (P<0.02).In the UBE group, the angle of lateral facet arthrotomy was 77.92°±12.17°, but in the UE group, it was 95.48°±11.98° (P<0.000). Conclusion Both UBE and UE have good short-term clinical efficacy in treating lumbar spinal stenosis; however, UBE has a better imaging decompression effect and can better preserve zygapophysial joint.