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Updated: Jan 8, 2026
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Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion
Published on: June 6, 2025
834
Patient-Reported and Radiographic Outcomes at Two Years Following Unilateral Biportal Endoscopic Fusion Extension for
Ji Soo Ha1, Jae-Koo Lee2, Piyush Gadegone1
1Department of Neurosurgery, Spine Center, Yonsei Okay Hospital, Uijeongbu, Republic of Korea.
Global Spine Journal
|December 11, 2025
Summary
Unilateral biportal endoscopic fusion-extension surgery (UBE-FES) effectively treats adjacent segment disease (ASD) after lumbar fusion, significantly reducing pain and improving function. This minimally invasive approach achieves high fusion rates with low complication risks.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Minimally Invasive Spine Surgery
Background:
- Adjacent segment disease (ASD) is a common complication following lumbar fusion surgery.
- Symptomatic ASD can lead to significant back and leg pain, impacting patient function and quality of life.
- Traditional revision surgeries for ASD often involve extensive open procedures with associated morbidity.
Purpose of the Study:
- To evaluate the mid-term clinical effectiveness of unilateral biportal endoscopic fusion-extension surgery (UBE-FES) for symptomatic ASD.
- To assess radiographic fusion rates and the safety profile of UBE-FES in this patient population.
- To compare UBE-FES outcomes against historical data for open revision procedures.
Main Methods:
- Retrospective cohort study of patients treated with UBE-FES for symptomatic ASD between March 2020 and March 2023.
- Inclusion criteria: new radicular or back pain from adjacent-level stenosis or Grade I-II spondylolisthesis post-lumbar fusion.
- Clinical outcomes (VAS, ODI, SF-36) and radiographic fusion (CT scans) were assessed at 24 months. Operative parameters and complications were recorded.
Main Results:
- Significant improvements in pain (VAS-Back and VAS-Leg) and function (ODI, SF-36 PF, BP) were observed at 24 months (P < 0.001).
- High fusion rates of 96.9% were achieved.
- Low complication rates, including one incidental durotomy (3.1%) and two asymptomatic cage subsidence events (6.3%), with no infections or new neurologic deficits.
Conclusions:
- Unilateral biportal endoscopic fusion-extension surgery (UBE-FES) demonstrates significant mid-term clinical effectiveness in patients with symptomatic adjacent segment disease (ASD).
- The procedure yields high radiographic fusion rates and a favorable safety profile with minimal morbidity.
- UBE-FES represents a viable and less invasive alternative to open revision surgery for managing ASD after prior lumbar fusion.
