Guo Song, Hang Rui-Ning, Zhu Kai, Wu Chen-Qiong, Yan Mei-Jun, Li Xin-Hua, Liu Yan-Bin, Fu Qiang
Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.
Department of Public Health Studies, Johns Hopkins University, Baltimore, MD 21218, United States.
World J Orthop. 2025 Jul 18;16(7):107698. doi: 10.5312/wjo.v16.i7.107698.
Uniportal full-endoscopy (UFE) technique has been continuously developed and applied for treating lumbar spinal stenosis. However, achieving effective decompression outcome of using the UFE technique remains technically demanding and uncertain. Previously, we have proposed the biportal full-endoscopy (BFE) technique to integrate the respective advantages of both UFE and unilateral biportal endoscopy technique. There is limited published data on the comparison of clinical outcomes between biportal and UFE techniques in lumbar spinal stenosis with bilateral symptoms.
To contrast the clinical outcomes between biportal and UFE techniques for treating lumbar spinal stenosis with bilateral symptoms.
This study retrospectively examined 100 patients diagnosed with lumbar spinal stenosis and bilateral symptoms. Among them, 52 cases were part of group A (BFE technique group), and 48 cases belonged to group B (UFE technique group). The visual analogue scale (VAS), Oswestry Disability Index (ODI), and modified Macnab criteria were used to evaluate the clinical outcomes.
Group A had significantly shorter operation time than group B. Both groups experienced substantial relief in lower back and lower extremity pain on the severe side at postoperative 3 days, 3 months, and 12 months. Group A had notably lower VAS scores for mild side lower extremity pain at postoperative 3 months and 12 months compared to group B. Group A's ODI scores were significantly lower at postoperative 3 months and 12 months, whereas group B's scores did not significantly differ from preoperative values. Group A's ODI scores were significantly lower than group B's at postoperative 3 months and 12 months. Group A had a significantly higher excellent and good response rate (94.23%) compared to group B (81.25%) at postoperative 12 months based on the modified Macnab scale outcomes.
The BFE technique offers multiple benefits, including reduced trauma and quicker recovery as a minimally invasive surgery, and enhanced decompression efficiency over the UFE technique when treating lumbar spinal stenosis with bilateral symptoms.
单孔全内镜（UFE）技术不断发展并应用于腰椎管狭窄症的治疗。然而，使用UFE技术实现有效的减压效果在技术上仍具有挑战性且不确定。此前，我们提出了双孔全内镜（BFE）技术，以整合UFE和单侧双孔内镜技术的各自优势。关于双侧症状的腰椎管狭窄症中双孔与UFE技术临床结果比较的已发表数据有限。
对比双孔和UFE技术治疗双侧症状腰椎管狭窄症的临床结果。
本研究回顾性分析了100例诊断为腰椎管狭窄症且有双侧症状的患者。其中，52例属于A组（BFE技术组），48例属于B组（UFE技术组）。采用视觉模拟量表（VAS）、Oswestry功能障碍指数（ODI）和改良Macnab标准评估临床结果。
A组手术时间明显短于B组。两组在术后3天、3个月和12个月时，下腰部和严重侧下肢疼痛均有显著缓解。与B组相比，A组在术后3个月和12个月时轻度侧下肢疼痛的VAS评分明显更低。A组在术后3个月和12个月时的ODI评分显著更低，而B组的评分与术前值无显著差异。A组在术后3个月和12个月时的ODI评分明显低于B组。基于改良Macnab量表结果，A组在术后12个月时的优良率（94.23%）明显高于B组（81.25%）。
BFE技术具有多种优势，作为微创手术，创伤更小、恢复更快，并且在治疗双侧症状的腰椎管狭窄症时，减压效率高于UFE技术。
