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Updated: Mar 13, 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
Uniportal Endoscopic Versus Microscopic Unilateral Laminotomy for Bilateral Decompression in the Treatment of Lumbar
Ruibin Feng1, Cong Pang, Depeng Ji
1Department of Joint and Spine Surgery, The Ninth Affiliated Hospital of Guangxi Medical University, Beihai, Guangxi, China.
Background:
The effectiveness of uniportal endoscopic and microscopic unilateral laminotomy for bilateral decompression (ULBD) in managing lumbar spinal stenosis (LSS) remains a subject of debate.
Objective:
This meta-analysis aims to provide evidence-based guidance for clinical decision-making in the treatment of elderly LSS patients.
Methods:
Databases (PubMed, Scopus, Cochrane, Embase, Web of Science) were searched from inception to September 2024 to identify relevant studies. The primary outcome measures included operative time, estimated blood loss, length of hospital stay, Visual Analog Scale (VAS) pain scores for both back and leg, Oswestry Disability Index (ODI) scores, and complication rates.
Results:
An analysis of five studies encompassing 349 LSS patients revealed that endoscopic ULBD (Endo-ULBD) provided superior long-term alleviation of back pain compared to microscopic ULBD (Micro-ULBD), although no significant difference was observed during early follow-up periods. Regarding leg pain, both approaches yielded comparable outcomes. Endo-ULBD demonstrated additional advantages, including shorter hospitalization durations, decreased blood loss, and a lower incidence of complications. Furthermore, early functional recovery, as assessed by ODI, was more favorable with Endo-ULBD, despite final functional outcomes being similar between the two techniques.
Conclusions:
This meta-analysis reveals that Endo-ULBD demonstrates superior long-term back pain relief compared to Micro-ULBD, while also offering significant early functional recovery advantages. Critically, both techniques were found to be equally effective in providing symptomatic relief for radicular leg pain, as measured by VAS leg scores. Although both procedures ultimately yield comparable functional outcomes, Endo-ULBD presents additional benefits, including reduced hospital stay duration, decreased blood loss, and lower complication rates. These findings underscore the distinct advantages of Endo-ULBD in LSS surgical interventions.
