Lobo Kaike, Łajczak Paweł, Rajab Numa, Santos Cláudia, Reis de Oliveira Rafael, Silva Yasmin P, Sharma Eshita, Silva Yan Gabriel M D, Barbosa Ramon Guerra
State University of Pará, Belém, Brazil.
Medical University of Silesia, Katowice, Poland.
Global Spine J. 2025 Apr 29:21925682251339999. doi: 10.1177/21925682251339999.
Study DesignSystematic review and meta-analysis.ObjectiveAlthough uniportal and biportal endoscopic decompression have emerged as promising minimally invasive options for the management of lumbar spinal stenosis (LSS), their relative advantages remain debated. This systematic review and meta-analysis aims to evaluate the efficacy and safety of both approaches in LSS treatment.MethodsIn adherence to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines, we systematically searched PubMed, Embase, Cochrane Library, and Web of science for randomized controlled trials and observational studies comparing the outcomes of uniportal and biportal endoscopic techniques for LSS treatment. Meta-analysis was performed using a random-effects model.ResultsA total of 11 studies were included, comprising 1199 patients. Biportal endoscopy was associated with a significantly lower operation time ( < .01), Oswestry Disability Index (ODI) at 12 months ( < .01), and higher postoperative dural sac area ( < .01) and dural sac area expansion ( = .02). There were no significant differences between groups in intraoperative blood loss, hospitalization time, back pain, leg pain, or ODI at other timepoints, ipsilateral facetectomy angle, and overall complications, including dural tear, infection, postoperative hematoma, lower limb numbness, and nerve root injury.ConclusionIn this meta-analysis, biportal endoscopic decompression demonstrated significantly lower operation time, ODI at 12 months, and higher postoperative dural sac area and dural sac area expansion, although both techniques showed similar safety profiles and complication rates. Further high-quality studies are needed to better assess the advantages of both techniques for LSS treatment.
系统评价与荟萃分析。
尽管单孔和双孔内镜减压已成为治疗腰椎管狭窄症（LSS）有前景的微创选择，但其相对优势仍存在争议。本系统评价与荟萃分析旨在评估这两种方法治疗LSS的疗效和安全性。
按照系统评价和荟萃分析的首选报告项目（PRISMA）指南，我们系统检索了PubMed、Embase、Cochrane图书馆和Web of science，以查找比较单孔和双孔内镜技术治疗LSS结果的随机对照试验和观察性研究。使用随机效应模型进行荟萃分析。
共纳入11项研究，包括1199例患者。双孔内镜检查的手术时间显著缩短（<0.01），12个月时的Oswestry功能障碍指数（ODI）显著降低（<0.01），术后硬脊膜囊面积显著增大（<0.01），硬脊膜囊面积扩大更明显（=0.02）。两组在术中失血量、住院时间、背痛、腿痛或其他时间点的ODI、同侧关节突切除角度以及包括硬膜撕裂、感染、术后血肿、下肢麻木和神经根损伤在内的总体并发症方面无显著差异。
在本荟萃分析中，双孔内镜减压的手术时间显著缩短，12个月时的ODI显著降低，术后硬脊膜囊面积和硬脊膜囊面积扩大更明显，尽管两种技术的安全性和并发症发生率相似。需要进一步的高质量研究来更好地评估这两种技术治疗LSS的优势。
