Uniportal versus unilateral biportal endoscopic decompression for degenerative lumbar spinal stenosis in elderly...

This study aims to investigate the clinical safety and efficacy between uniportal and unilateral biportal endoscopic (UBE) decompression in elderly patients suffering degenerative lumbar spinal stenosis (DLSS).

From January 2021 to June 2024, 143 participants were included (37 in uniportal group and 106 in UBE group). Assessment indicators included operation duration, complication occurrence, visual analogue scale (VAS) of low back and leg, Japanese Orthopedic Association score (JOA), Oswestry Disability Index (ODI), modified MacNab criteria (outcome satisfaction) and cross-sectional area of dural sac in operated level.

VAS (leg) in UBE group was significantly less than that in uniportal group at both postoperation immediately and last follow-up. While VAS (back), JOA, ODI, Excellent-Good proportion and cross-sectional area of dural sac in operated level showed no statistical difference between the two groups at all time points. For VAS (back and leg), JOA, ODI in both uniportal and UBE groups, all data were improved significantly at postoperation immediately when compared with those before surgery, and these data continued to improve statistically at last follow-up in comparison with those at postoperation immediately.

For elderly people suffering DLSS, both uniportal and UBE decompression have significant pain reduction and functional improvement in daily activities. The latter is more effective in pain relief of lower limbs. For elderly people with DLSS primarily presenting with lower limb pain, UBE decompression may be more appropriate.