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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Comparison of clinical outcomes between biportal and uniportal full-endoscopy techniques in lumbar spinal stenosis with bilateral symptoms
Song Guo, Rui-Ning Hang, Kai Zhu, Chen-Qiong Wu, Mei-Jun Yan, Xin-Hua Li, Yan-Bin Liu, Qiang Fu
Song Guo, Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
Rui-Ning Hang, Department of Public Health Studies, Johns Hopkins University, Baltimore, MD 21218, United States
Kai Zhu, Department of Spine Surgery, Qingdao No. 8 People's Hospital, Qingdao 266121, Shandong Province, China
Chen-Qiong Wu, Yan-Bin Liu, Department of Spine Surgery, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
Mei-Jun Yan, Xin-Hua Li, Department of Orthopedics Surgery, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
Qiang Fu, Department of Spine Surgery, Shanghai General Hospital, Shanghai 200080, China
Author contributions: Guo S, Hang RN, and Zhu K designed the research study; Guo S, Hang RN, and Wu CQ performed the research; Guo S, Hang RN, Wu CQ, and Liu YB analyzed the data and wrote the manuscript; Zhu K, Yan MJ, and Li XH collected the data; Fu Q performed all the surgeries in the article; all authors have read and approve the final manuscript.
Supported by National Natural Science Foundation of China, No. 82202694; and Clinical Research Innovation Plan of Shanghai General Hospital, No. CTCCR-2021C10.
Institutional review board statement: This study was approved by The Ethics Committee of Shanghai General Hospital (2022SQ011), and the study was conducted in accordance with the Declaration of Helsinki.
Informed consent statement: All participants provided informed consent to participate.
Conflict-of-interest statement: The authors declare that there are no competing interests.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Qiang Fu, MD, PhD, Chief Physician, Department of Spine Surgery, Shanghai General Hospital, No. 100 Haining Road, Shanghai 200080, China.
2293259778@qq.com
Received: March 28, 2025
Revised: May 4, 2025
Accepted: June 13, 2025
Published online: July 18, 2025
Processing time: 111 Days and 19.7 Hours
BACKGROUND
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.
AIM
To contrast the clinical outcomes between biportal and UFE techniques for treating lumbar spinal stenosis with bilateral symptoms.
METHODS
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.
RESULTS
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.
CONCLUSION
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.
Core Tip: The clinical efficacy of the uniportal full-endoscopy (UFE) technique in decompressing lumbar spinal stenosis is technically difficult and uncertain. Therefore, to overcome these limitations, we previously proposed the biportal full-endoscopy technique, which combines the advantages of both UFE and unilateral biportal endoscopy. The following is a retrospective comparison of clinical outcomes of biportal and UFE methods in the treatment of lumbar spinal stenosis with bilateral symptoms. According to the results, the biportal method has some benefits over the uniportal method such as less trauma during surgery, faster recovery time, and improved decompression efficiency of the affected regions.
