Comparison of clinical outcomes between biportal and uniportal full-endoscopy techniques in lumbar spinal stenosis with bilateral symptoms

Figure 1 Illustrative cases utilizing the spine biportal full-endoscopy technique for managing lumbar spinal stenosis with bilateral symptoms. A: Full uniportal endoscopic mode (single channel); B: Full unilateral biportal endoscopy mode (dual channels); C and D: Observation channel and working channel interchanged mode; E: Dual working channel mode; F: Hemostasis using spinal radiofrequency in the uniportal mode; G: Articular process resection executed with a trephine within the uniportal framework; H: Decompression performed utilizing an endoscopy punch in the uniportal mode; I: Herniated nucleus pulposus probed using radiofrequency within the uniportal mode; J: Radiofrequency-induced soft tissue ablation conducted in the biportal mode; K: Osteotome-driven decompression carried out in the biportal configuration; L: Decompression accomplished through a conventional punch in the biportal mode; M: Nerve root loosening subsequent to decompression.

Figure 2 Illustrative instances of bilateral symptomatic lumbar spinal stenosis managed using the uniportal full-endoscopy technique. A: Uniportal full-endoscopy technique (single channel); B: Articular process resection executed with a trephine in uniportal endoscopy; C: Radiofrequency hemostasis under uniportal endoscopy; D: Articular process resection executed with a trephine in uniportal endoscopy; E: Laminectomy by endoscopic punch; F: Osteophyte decompression by endoscopic high-speed grinding drill; G: Resection of ligamentum flavum by endoscopic punch; H: Exploring the proximal endpoint of the ligamentum flavum using a nerve hook; I: Exploring the distal endpoint of the ligamentum flavum using a nerve hook; J: Exploring the lateral endpoint of the ligamentum flavum using a nerve hook; K: Hemostasis on nerve tissue using spinal radiofrequency; L: Neural relaxation post-decompression.

Figure 3 Clinical outcomes in both groups. A: Comparison of lower back pain scores between the two groups; B: Comparison of lower extremity pain (severe side) between the two groups; C: Comparison of lower extremity pain (mild side) between the two groups; D: Comparison of quality of life Oswestry Disability Index scores between the two groups. ^aP < 0.05: Means there was significant difference before and after operation (P < 0.05); ^bP < 0.05: Means there was significant difference between groups (P < 0.05). ODI: Oswestry Disability Index; VAS: Visual analogue scale.