Biportal endoscopic spinal surgery for lumbar spinal stenosis

Abstract

Lumbar spinal stenosis is a common disease in the elderly (over 60 years old). Common surgical options for treating lumbar stenosis include open decompression laminectomy, foraminotomy, and spinal fusion. Currently, the gold standard for treating lumbar stenosis that is resistant to conservative treatment is laminectomy with facet preservation.The purpose is to conduct a comparative assessment of the results of studies of the effectiveness and advantages of unilateral biportal endoscopy (UBE) in comparison with other methods of decompression of lumbar spinal stenosis based on the literature data.Results. A meta-analysis of the studies showed that the advantage of UBE is the possibility of preventing atrophy of the paraspinal muscles due to a decrease in muscle dissection and retraction compared to open decompression. This technique allows reducing the trauma of the nerve structures since it is possible to carry out manipulations finely and accurately due to significantly enlarged images. Also, due to the wide viewing angle through the endoscope, decompression of the contralateral side is relatively simple.Conclusions. The UBE technique has several advantages compared to other minimally invasive methods, namely, reduction of damage to the posterior ligamentous apparatus and soft tissues, complete decompression of damaged structures and lower risk of infection.