Indications for and Outcomes of Three Unilateral Biportal Endoscopic Approaches for the Decompression of Degenerative Lumbar Spinal Stenosis: A Systematic Review
Objective: In this systematic review, we summarized the indications for and outcomes of three main unilateral biportal endoscopic (UBE) approaches for the decompression of degenerative lumbar spinal stenosis (DLSS). Methods: A comprehensive search of the literature was performed using Ovid Embase, P...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/6/1092 |
| _version_ | 1827750334103027712 |
|---|---|
| author | Anh Tuan Bui Giam Minh Trinh Meng-Huang Wu Tung Thanh Hoang Ming-Hsiao Hu Jwo-Luen Pao |
| author_facet | Anh Tuan Bui Giam Minh Trinh Meng-Huang Wu Tung Thanh Hoang Ming-Hsiao Hu Jwo-Luen Pao |
| author_sort | Anh Tuan Bui |
| collection | DOAJ |
| description | Objective: In this systematic review, we summarized the indications for and outcomes of three main unilateral biportal endoscopic (UBE) approaches for the decompression of degenerative lumbar spinal stenosis (DLSS). Methods: A comprehensive search of the literature was performed using Ovid Embase, PubMed, Web of Science, and Ovid’s Cochrane Library. The following information was collected: surgical data; patients’ scores on the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Macnab criteria; and surgical complications. Results: In total, 23 articles comprising 7 retrospective comparative studies, 2 prospective comparative studies, 12 retrospectives case series, and 2 randomized controlled trials were selected for quantitative analysis. The interlaminar approach for central and bilateral lateral recess stenoses, contralateral approach for isolated lateral recess stenosis, and paraspinal approach for foraminal stenosis were used in 16, 2, and 4 studies, respectively. In one study, both interlaminar and contralateral approaches were used. L4-5 was the most common level decompressed using the interlaminar and contralateral approaches, whereas L5-S1 was the most common level decompressed using the paraspinal approach. All three approaches provided favorable clinical outcomes at the final follow-up, with considerable improvements in patients’ VAS scores for leg pain (63.6–73.5%) and ODI scores (67.2–71%). The overall complication rate was <6%. Conclusions: The three approaches of UBE surgery are effective and safe for the decompression of various types of DLSS. In the future, long-term prospective studies and randomized control trials are warranted to explore this new technique further and to compare it with conventional surgical techniques. |
| first_indexed | 2024-03-11T06:42:22Z |
| format | Article |
| id | doaj.art-fe3ad16d84a8404abac035545fb84a9c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T06:42:22Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-fe3ad16d84a8404abac035545fb84a9c2023-11-17T10:34:14ZengMDPI AGDiagnostics2075-44182023-03-01136109210.3390/diagnostics13061092Indications for and Outcomes of Three Unilateral Biportal Endoscopic Approaches for the Decompression of Degenerative Lumbar Spinal Stenosis: A Systematic ReviewAnh Tuan Bui0Giam Minh Trinh1Meng-Huang Wu2Tung Thanh Hoang3Ming-Hsiao Hu4Jwo-Luen Pao5International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110, TaiwanInternational Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110, TaiwanDepartment of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, TaiwanDepartment of Spine Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi 10000, VietnamDepartment of Orthopedic Surgery, National Taiwan University Hospital, Taipei 100, TaiwanDepartment of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, TaiwanObjective: In this systematic review, we summarized the indications for and outcomes of three main unilateral biportal endoscopic (UBE) approaches for the decompression of degenerative lumbar spinal stenosis (DLSS). Methods: A comprehensive search of the literature was performed using Ovid Embase, PubMed, Web of Science, and Ovid’s Cochrane Library. The following information was collected: surgical data; patients’ scores on the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Macnab criteria; and surgical complications. Results: In total, 23 articles comprising 7 retrospective comparative studies, 2 prospective comparative studies, 12 retrospectives case series, and 2 randomized controlled trials were selected for quantitative analysis. The interlaminar approach for central and bilateral lateral recess stenoses, contralateral approach for isolated lateral recess stenosis, and paraspinal approach for foraminal stenosis were used in 16, 2, and 4 studies, respectively. In one study, both interlaminar and contralateral approaches were used. L4-5 was the most common level decompressed using the interlaminar and contralateral approaches, whereas L5-S1 was the most common level decompressed using the paraspinal approach. All three approaches provided favorable clinical outcomes at the final follow-up, with considerable improvements in patients’ VAS scores for leg pain (63.6–73.5%) and ODI scores (67.2–71%). The overall complication rate was <6%. Conclusions: The three approaches of UBE surgery are effective and safe for the decompression of various types of DLSS. In the future, long-term prospective studies and randomized control trials are warranted to explore this new technique further and to compare it with conventional surgical techniques.https://www.mdpi.com/2075-4418/13/6/1092endoscopybiportalspinal stenosislumbar vertebrae |
| spellingShingle | Anh Tuan Bui Giam Minh Trinh Meng-Huang Wu Tung Thanh Hoang Ming-Hsiao Hu Jwo-Luen Pao Indications for and Outcomes of Three Unilateral Biportal Endoscopic Approaches for the Decompression of Degenerative Lumbar Spinal Stenosis: A Systematic Review Diagnostics endoscopy biportal spinal stenosis lumbar vertebrae |
| title | Indications for and Outcomes of Three Unilateral Biportal Endoscopic Approaches for the Decompression of Degenerative Lumbar Spinal Stenosis: A Systematic Review |
| title_full | Indications for and Outcomes of Three Unilateral Biportal Endoscopic Approaches for the Decompression of Degenerative Lumbar Spinal Stenosis: A Systematic Review |
| title_fullStr | Indications for and Outcomes of Three Unilateral Biportal Endoscopic Approaches for the Decompression of Degenerative Lumbar Spinal Stenosis: A Systematic Review |
| title_full_unstemmed | Indications for and Outcomes of Three Unilateral Biportal Endoscopic Approaches for the Decompression of Degenerative Lumbar Spinal Stenosis: A Systematic Review |
| title_short | Indications for and Outcomes of Three Unilateral Biportal Endoscopic Approaches for the Decompression of Degenerative Lumbar Spinal Stenosis: A Systematic Review |
| title_sort | indications for and outcomes of three unilateral biportal endoscopic approaches for the decompression of degenerative lumbar spinal stenosis a systematic review |
| topic | endoscopy biportal spinal stenosis lumbar vertebrae |
| url | https://www.mdpi.com/2075-4418/13/6/1092 |
| work_keys_str_mv | AT anhtuanbui indicationsforandoutcomesofthreeunilateralbiportalendoscopicapproachesforthedecompressionofdegenerativelumbarspinalstenosisasystematicreview AT giamminhtrinh indicationsforandoutcomesofthreeunilateralbiportalendoscopicapproachesforthedecompressionofdegenerativelumbarspinalstenosisasystematicreview AT menghuangwu indicationsforandoutcomesofthreeunilateralbiportalendoscopicapproachesforthedecompressionofdegenerativelumbarspinalstenosisasystematicreview AT tungthanhhoang indicationsforandoutcomesofthreeunilateralbiportalendoscopicapproachesforthedecompressionofdegenerativelumbarspinalstenosisasystematicreview AT minghsiaohu indicationsforandoutcomesofthreeunilateralbiportalendoscopicapproachesforthedecompressionofdegenerativelumbarspinalstenosisasystematicreview AT jwoluenpao indicationsforandoutcomesofthreeunilateralbiportalendoscopicapproachesforthedecompressionofdegenerativelumbarspinalstenosisasystematicreview |