CLINICAL AND FUNCTIONAL EFFECTIVENESS OF UNILATERAL BIPORTAL ENDOSCOPIC DECOMPRESSION IN DEGENERATIVE LUMBAR SPINAL CANAL STENOSIS: A SINGLE-CENTER OBSERVATIONAL STUDY

Abstract

Degenerative lumbar spinal canal stenosis is a frequent cause of neurogenic claudication, radicular pain, functional restriction, and disability in middle-aged and elderly patients. Although conventional open decompression remains effective, it may be associated with paravertebral muscle injury, iatrogenic destabilization, postoperative pain, prolonged hospitalization, and delayed recovery. Unilateral biportal endoscopic decompression (UBE) is a minimally invasive posterior technique that enables bilateral neural decompression through two small portals while preserving ligamentous structures, facet joints, and paraspinal muscles. This single-center observational study evaluated the clinical, functional, radiological, and perioperative effectiveness of UBE in 48 patients with symptomatic degenerative lumbar spinal stenosis. Inclusion criteria were neurogenic claudication or radiculopathy resistant to conservative treatment, magnetic resonance imaging signs of central or lateral recess stenosis, and functional impairment according to the Oswestry Disability Index (ODI). Outcomes included VAS scores, ODI, walking distance, neurological status, modified MacNab criteria, dural sac area, operative parameters, hospitalization, and complications. UBE resulted in significant postoperative improvement. Mean VAS leg pain decreased from 7.6 ± 1.1 to 1.9 ± 0.8 at 6 months, while ODI improved from 58.4 ± 9.6% to 18.7 ± 7.5%. Pain-free walking distance increased from 145 ± 68 m to 860 ± 240 m, and dural sac area increased from 61.8 ± 18.7 mm² to 128.6 ± 31.4 mm². Excellent or good MacNab outcomes were achieved in 87.5% of patients. Complications were limited, with no postoperative instability or infection. UBE appears to be an effective tissue-preserving alternative for properly selected patients with degenerative lumbar spinal canal stenosis.