Comparative study of unilateral biportal endoscopy and coaxial large channel endoscopy for lumbar spinal stenosis

Abstract

Objective: To compare the efficacy of unilateral biportal endoscopy (UBE) and coaxial large channel endoscopy for lumbar spinal stenosis. Methods: A total of 176 patients with lumbar spinal stenosis treated in Tianjin Hospital from March 2015 to October 2021 were included in this study. Of the patients, 110 cases were treated with UBE, including 52 males and 58 females, with a mean age of (75.1±10.4) years; while 66 cases were treated with coaxial large channel endoscopy, including 31 males and 35 females, with an average age of (77.2±13.1) years. The visual analogue scale (VAS) score of pain and Oswestry disability index (ODI) were compared before and after surgery between the two groups, with the improvement rate calculated. The operation time, intraoperative blood loss, perioperative conditions and complications were compared. The operation efficacy was evaluated according to MacNab scale and was compared between the two groups. Results: There was no significant differences in age, gender, disease course, VAS of pain, ODI and index levels between the two groups before operation (all P>0.05). The operation time and postoperative drainage in UBE group and coaxial large channel endoscopy group were comparable [(60.1±12.4)min, (62.5±13.2)min and (103.8±20.7)ml, (98.5±22.1)ml, respectively, both P>0.05]. After the operation, the VAS score of low back pain, VAS score of leg pain and ODI of the two groups were all lower than those before operation, and decreased continuously during follow-up; and under the repeated measures analysis of variance, significant differences were found between different time points (all P<0.05), no significant difference was found between the two groups (all P>0.05), nor interaction between groups and time points was detected (all P>0.05). The patients were followed-up for (18.0±4.2) months (6 to 30 months). There was no significant difference in VAS and ODI improvement rates and excellent rate of efficacy between the two groups at the last follow-up (all P>0.05). Conclusions: Both UBE and coaxial large channel endoscopy can provide excellent results for lumbar spinal stenosis. UBE has sufficient decompression and is convenient to explore and remove the herniated disc.