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Updated: Oct 16, 2026
The Third Channel-Assisted Unilateral Biportal Endoscopic Technique for Lumbar Spinal Stenosis Combined with Contralateral Disc Herniation
Published on: November 17, 2023
Dual-media spinal endoscopy versus unilateral biportal endoscopy for single-level degenerative lumbar spinal
Ruixiong Du1,2, Taotao Lin1, Xianfeng Lin1
1Fujian Medical University Union Hospital, Fujian, China.
Purpose:
To compare the clinical and radiographic outcomes of dual-media spinal endoscopy (DMSE), a single-portal endoscopic system allowing flexible air-water switching, with unilateral biportal endoscopy (UBE) in the treatment of single-level degenerative lumbar spinal stenosis (DLSS).
Methods:
A retrospective analysis was performed on 105 patients diagnosed with single-level DLSS who underwent either DMSE (n = 48) or UBE (n = 57) between January 2023 and June 2024. Visual Analogue Scale (VAS) scores for back and leg pain and Japanese Orthopaedic Association (JOA) scores were recorded preoperatively and at 3 days, 1, 3, 6, and 12 months postoperatively. Radiographic parameters included facet resection rate, dural sac expansion, and decompression ratio. Serum creatine kinase (CK) changes and perioperative complications were also evaluated.
Results:
Both groups demonstrated significant improvements in low-back pain, leg pain, and JOA scores from 1 month through 12 months postoperatively (all p < 0.001). Unadjusted between-group differences in back-pain VAS (p = 0.034) and leg-pain VAS (p = 0.023) at 12 months did not remain statistically significant after Holm adjustment (adjusted p = 0.170 and 0.115, respectively).The fluoroscopy frequency was significantly lower in the DMSE group than in the UBE group(4 vs. 8 ; p < 0.001). The facet resection rate was significantly higher in DMSE (28.6 ± 13.7%) than in UBE (20.3 ± 12.1%; p = 0.001), and postoperative serum CK elevation was greater in DMSE (p = 0.010). Complication rates did not differ significantly between groups (2.1% vs. 1.8%; p > 0.05).
Conclusions:
Both DMSE and UBE appear to be safe and effective minimally invasive procedures for patients with single-level DLSS, with generally comparable short- to mid-term clinical outcomes. DMSE was associated with lower fluoroscopy frequency but greater facet resection, whereas UBE showed lower early postoperative CK elevation. These findings suggest different perioperative and technical profiles rather than clear overall superiority of either technique.