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The Third Channel-Assisted Unilateral Biportal Endoscopic Technique for Lumbar Spinal Stenosis Combined with Contralateral Disc Herniation
Published on: November 17, 2023
Unilateral Biportal Endoscopy versus Open Surgery for Thoracolumbar Burst Fractures with Neurological Deficit: A
Si-Huai Wang1, Jui-Ting Mao2, Chun-Hong Lo2
1Department of Education, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
World Neurosurgery
|August 5, 2026
Summary
Unilateral biportal endoscopy (UBE) with percutaneous pedicle screw fixation (PPSF) offers a minimally invasive option for thoracolumbar burst fractures, reducing blood loss and hospital stays while achieving comparable outcomes to open surgery.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Thoracolumbar burst fractures with neurological deficits require effective surgical decompression and stabilization.
- Traditional open surgery carries significant morbidity.
- Minimally invasive techniques are being explored to improve patient outcomes.
Purpose of the Study:
- To compare the outcomes of unilateral biportal endoscopy (UBE) decompression with percutaneous pedicle screw fixation (PPSF) against open surgery for thoracolumbar burst fractures.
- To evaluate perioperative metrics, clinical outcomes, and anatomical restoration.
Main Methods:
- Retrospective analysis of 38 patients with T11-L2 burst fractures (ASIA C-D).
- Comparison between 18 patients treated with UBE-assisted decompression and PPSF versus 20 patients treated with open decompression and instrumentation.
- Assessment of clinical scores (VAS, ODI), neurological recovery, and vertebral body height restoration at 1, 6, and 12 months postoperatively.
Main Results:
- The UBE group had significantly lower median blood loss (125 vs. 475 mL), fewer transfusions (5.6% vs. 40%), and shorter hospital stays (7 vs. 12 days).
- UBE demonstrated superior vertebral body height restoration (38% vs. 23%).
- Both groups showed comparable functional and neurological improvements at all follow-up points.
Conclusions:
- UBE combined with PPSF is a feasible, minimally invasive alternative for thoracolumbar burst fractures.
- This technique significantly reduces early surgical morbidity and achieves robust anatomical restoration with comparable clinical outcomes.
- Larger prospective studies are needed to confirm long-term safety and efficacy.