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Updated: Aug 23, 2026
Percutaneous Endoscopic Unilateral-Approach Bilateral Decompression for Lumbar Spinal Stenosis
Published on: February 9, 2024
Effects of Sarcopenia on Surgical Outcomes After Biportal Endoscopic Lumbar Decompression and Fusion: A Retrospective
Tae-Soung Kim1, Ki-Han You2, Seung-Yeon Jeong2
1Department of Orthopaedic Surgery, Hallym University College of Medicine, Dongtan Sacred Heart Hospital, Gyeonggi-do, Republic of Korea.
Study Design:
Retrospective, single-center study.
Objective:
To evaluate the effects of sarcopenia on perioperative parameters and postoperative outcomes in patients undergoing biportal endoscopic lumbar surgery.
Summary Of Background Data:
Sarcopenia is associated with adverse surgical outcomes. However, its impact on minimally invasive procedures, particularly biportal endoscopic lumbar surgery, remains unclear.
Methods:
We retrospectively analyzed data from 153 patients who underwent biportal endoscopic lumbar surgery (decompression, n=101; fusion, n=52) between October 2021 and November 2023. Patients were classified into sarcopenia and non-sarcopenia groups based on appendicular skeletal muscle mass (ASM), handgrip strength, and 6-m gait speed. Demographic characteristics, perioperative parameters, clinical outcomes, and complication rates were compared between the groups. Outcomes were assessed from the preoperative period to 12 months postoperatively.
Results:
ASM and 6-m gait speed were significantly lower in patients with sarcopenia, within both decompression and fusion cohorts (P<0.001). The Oswestry Disability Index and EuroQol-5D index improved in all groups, without significant between-group differences at 12 months postoperatively. In the fusion group, patients with sarcopenia had a significantly longer hospital stay (15.0 vs. 11.9 d, P=0.003), despite similar operative time and estimated blood loss. Postoperative C-reactive protein and creatine phosphokinase levels were higher in patients with sarcopenia undergoing fusion, without reaching significance. Complication rates were equivalent in all groups.
Conclusions:
Sarcopenia was not associated with inferior clinical outcomes or higher complication rates following biportal endoscopic lumbar surgery. However, patients with sarcopenia undergoing fusion surgery experienced a longer hospital stay, suggesting delayed early postoperative recovery. Overall, biportal endoscopic lumbar surgery may be an acceptable surgical option for patients with sarcopenia.