A meta-analysis of clinical effects of microscopic unilateral laminectomy bilateral decompression (ULBD) versus biportal endoscopic ULBD for lumbar canal stenosis

Abstract

OsbjectiveSeveral studies have shown that both microscopic unilateral laminotomy bilateral decompression (ULBD) and unilateral biportal endoscopic (UBE) ULBD are effective for treating lumbar canal stenosis (LCS). However, there are different viewpoints as to which surgical technique is superior. Therefore, this meta-analysis investigated the clinical efficacy and side effects of microscopic ULBD and UBE ULBD for treating LCS.MethodsTo identify relevant studies describing the clinical outcomes and complication rates of microscopic ULBD and UBE ULBD for LCS, several databases were systematically searched in the Internet. The visual analog scale score for back and leg pain and the Oswestry Disability Index were used to assess clinical outcomes. Furthermore, data about perioperative outcomes and complications were documented.ResultsIn total, six studies with 450 participants were included in this meta-analysis. The UBE ULBD was found to be superior to microscopic ULBD in terms of efficacy against early postoperative back and leg pain. However, there was no significant difference between the two procedures in terms of final clinical outcomes and complications. In addition, compared with microscopic ULBD, UBE ULBD was associated with a significant reduction in the length of hospital stay and C-reactive protein levels 2 days after surgery.ConclusionUBE ULBD and microscopic ULBD for the treatment of LCS were similar in terms of final clinical outcomes and complications. However, UBE ULBD has several advantages over microscopic ULBE, including a shorter hospital stay and faster alleviation of postoperative back and leg pain.

Early Clinical and Radiologic Evaluation of Unilateral Biportal Endoscopic Unilateral Laminotomy and Bilateral Decompression in Degenerative Lumbar Spinal Stenosis: A Retrospective Study

“…According to a meta-analysis, 27 UBE ULBD complications occurred in 5.8% cases, and the most prevalent complications were dura tear and hematoma. In our study, the total complication rate of UBE surgery was 9.8%, which was higher than the previous report.…”

“…According to a meta-analysis [27] , the incidence of UBE ULBD complications was 5.8%, and the most prevalent complications were dura tear and hematoma. In our study, the total complication This article is protected by copyright.…”

Spinal canal stenosis: comparative analysis of minimally invasive bilateral decompression through a unilateral approach and laminectomy

“…По данным литературы [22,23,[34][35][36], унилатеральная декомпрессия укладывается в адекватные временные рамки, приводит к небольшой кровопотере и меньшему потреблению анальгетиков в сравнении с классической методикой ламинэктомии. Малоинвазивные методы хирургического лечения приводят к снижению частоты интраоперационных осложнений [37]. Все эти преимущества позволяют проводить подобные вмешательства под местной анестезией при наличии противопоказаний к общей анестезии у коморбидных пациентов [38].…”

A case report: Unilateral biportal endoscopic revision for adjacent segmental disease: Case presentations and literature review

“…Heo, [20] in a study with 3 groups (biportal endoscopy, uniportal endoscopy, and microsurgery) with at least 1 year of follow-up, has reported that UBE showed benefits in terms of avoiding postoperative facet joint violation and reduced immediate postoperative pain. Other studies [21][22][23][24][25] have also drawn attention to the advantages of a shorter hospitalization period and less postoperative back pain when compared with microscopic decompression. In our case, the epidural fat stuck with the dura mater was carefully removed with pituitary forceps, and full decompression was confirmed when the medial walls of bilateral pedicles were visualized.…”