Unilateral uniportal endoscopy with unilateral fixation for lumbar degenerative diseases: A retrospective...

ObjectiveFor lumbar degenerative diseases, minimizing surgical trauma while maintaining fusion stability remains challenging. This retrospective observational study and technical note describes a modified unilateral uniportal endoscopic technique combined with unilateral pedicle screw fixation and evaluated preliminary clinical and radiological outcomes, focusing on cage subsidence and migration.MethodsEighteen consecutive patients with single-level lumbar degenerative disease who underwent unilateral uniportal endoscopy with unilateral screw fixation between January 2025 and June 2025 were included. Clinical outcomes were assessed using the visual analog scale for back pain and leg pain as well as the Oswestry Disability Index. Radiological outcomes included disc height, disc height loss, cage migration, maximal cage penetration depth, cage subsidence, and Bridwell grading.ResultsThe mean age of the study population was 57.8 ± 9.5 years. The operated level was L4/5 in nine patients and L5/S1 in nine patients. The mean operative time was 146.4 ± 26.2 min, and mean blood loss was 87.8 ± 20.7 mL. Visual analog scale scores for back pain and leg pain as well as the Oswestry Disability Index scores improved postoperatively and were maintained at 12 months. Mean disc height increased from 11.4 ± 2.0 mm preoperatively to 14.4 ± 1.9 mm on postoperative day 3 and was 13.6 ± 1.9 mm at 6 months. Radiological measurements at 12 months postoperatively were available for 13 patients, with a mean disc height of 13.3 ± 2.0 mm. Cage subsidence >2 mm occurred in three patients (16.7%) at 6 months and two of the 13 patients (15.4%) at 12 months. Cage migration >3 mm occurred in one patient at both 6 months and 12 months. No screw loosening, screw breakage, or neurological deterioration occurred, and no patient required revision surgery.ConclusionsUnilateral uniportal endoscopy with unilateral screw fixation may be feasible for carefully selected patients with single-level lumbar degenerative disease. Satisfactory clinical outcomes are achieved; however, cage subsidence and migration may occur. Larger comparative studies with longer follow-up duration are required.