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Updated: Jan 10, 2026
Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
Published on: February 9, 2024
Clinical outcomes of navigation-assisted versus fluoroscopy-guided UBE-ULBD in single-level lumbar spinal stenosis: a
Shi-Jie Liu1, Si-Yuan Yao1, Yao Zhang1
1Department of Spinal Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, tieyi road, Yangfangdian, Haidian district, Beijing, 100038, People's Republic of China.
Background:
Lumbar spinal stenosis (LSS) is a common degenerative disorder characterized by neural compression, leading to radicular pain, neurogenic claudication, and lower limb dysfunction. Unilateral biportal endoscopic unilateral laminotomy for bilateral decompression (UBE-ULBD) has emerged as an effective minimally invasive surgical technique, but it requires advanced surgical skills and has a steep learning curve. The use of computer-assisted navigation has been increasingly adopted to improve surgical efficiency and safety; however, its clinical effectiveness and safety in UBE-ULBD for single-level LSS remain insufficiently investigated.
Methods:
A total of 119 patients undergoing UBE-ULBD were included and divided into Group A (navigation-assisted, n = 57) and Group B (fluoroscopy-guided, n = 62), with a minimum follow-up of 12 months. Perioperative outcomes and clinical efficacy were evaluated using operative time, fluoroscopy frequency, estimated blood loss, postoperative hospital stay, complication rates, as well as visual analogue scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI), and modified MacNab criteria.
Results:
No statistically significant differences were observed in baseline characteristics between the two groups. Group A had a significantly shorter operative time, fewer intraoperative fluoroscopies, and lower estimated blood loss compared with Group B (all P < 0.001), while postoperative hospital stay and overall complication rates did not differ significantly (P > 0.05). No surgical site infections or permanent nerve injuries occurred in either group. Both groups showed significant postoperative improvements in VAS and ODI scores relative to preoperative values; however, no intergroup differences were found at any follow-up point (P > 0.05). At the final follow-up, the excellent/good rate based on the modified MacNab criteria was 93.0% in Group A and 87.1% in Group B, with no significant difference (P > 0.05).
Conclusion:
Navigation-assisted UBE-ULBD can significantly improve surgical efficiency and markedly reduce intraoperative radiation exposure for surgeons, while demonstrating comparable safety and clinical efficacy to conventional fluoroscopy-guided procedures. These advantages highlight its potential clinical value as a safer and more efficient alternative for minimally invasive decompression in lumbar spinal stenosis.
