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Objective <p>To assess the clinical effectiveness of unilateral biportal endoscopy (UBE) in the treatment of lumbar spinal stenosis complicated with degenerative lumbar scoliosis and to analyze the influence of different facet joint preservation rates on clinical outcomes.</p> Methods <p>A retrospective analysis was performed on 87 patients with LSS complicated with DLS who underwent UBE in our hospital from January 2020 to January 2024, with a coronal Cobb angle ranging from 10° to 30°. Patient demographics, perioperative parameters, imaging data, and clinical outcomes were collected. Secondary exploratory subgroup analysis was performed according to the postoperative facet joint preservation rate. Patients were divided into group A (preservation rate 75%–100%, <i>n</i> = 39) and group B (preservation rate 50%–75%, <i>n</i> = 48). Demographic, perioperative, imaging, and clinical outcomes of the two groups were compared.</p> Results <p>The mean age of the patients was 65.83 ± 7.22&#xa0;years, and the surgical segments were mainly at L4/5; the mean operation time was 85.39 ± 7.22&#xa0;min, the mean hemoglobin reduction was 13.46 ± 3.40&#xa0;g/L, the mean hospital stay was 5.31 ± 2.81&#xa0;days. There were no significant changes in imaging parameters at the final follow-up compared with preoperative values. The intra-group comparison showed that low back pain VAS, leg pain VAS, and ODI scores at each postoperative follow-up time point were significantly lower than those preoperatively (<i>P</i> &lt; 0.001), whereas low back pain VAS, leg pain VAS, and ODI scores at 1&#xa0;year postoperatively were higher than those at 6&#xa0;months postoperatively (<i>P</i> &lt; 0.001). The postoperative complication rate was 13.8% (12/87). The excellent and good rate of modified MacNab criteria was 82.8% at the final follow-up. Secondary exploratory subgroup analysis revealed no statistically significant differences between groups A and B in baseline data, preoperative and final follow-up imaging parameters, low back pain VAS, leg pain VAS, ODI scores at each time point, postoperative complication rate, as well as the excellent and good rate of the modified MacNab criteria at final follow-up (<i>P</i> &gt; 0.05). Only operation time in group B was longer than that in group A (<i>P</i> = 0.028).</p> Conclusion <p>For patients with mild-to-moderate LSS complicated with DLS, UBE can alleviate clinical symptoms. Based on static imaging findings, lumbar spine stability can be maintained postoperatively over a certain follow-up period. Therefore, UBE represents a viable therapeutic option in clinical practice. Nevertheless, further research is needed to assess longer-term clinical outcomes in the future.</p>

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Application of unilateral biportal endoscopy in lumbar spinal stenosis complicated with degenerative lumbar scoliosis and evaluation of postoperative lumbar spinal stability

  • 期刊论文

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  • 发表日期：

    2026年7月21日

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  • Zhifeng Cheng,
  • Tao Tang,
  • Lei Sun,
  • Zhijun Chen,
  • Youchang Yuan,
  • Haonan Lu,
  • Hao Xu,
  • Bo Hu

摘要

Objective

To assess the clinical effectiveness of unilateral biportal endoscopy (UBE) in the treatment of lumbar spinal stenosis complicated with degenerative lumbar scoliosis and to analyze the influence of different facet joint preservation rates on clinical outcomes.

Methods

A retrospective analysis was performed on 87 patients with LSS complicated with DLS who underwent UBE in our hospital from January 2020 to January 2024, with a coronal Cobb angle ranging from 10° to 30°. Patient demographics, perioperative parameters, imaging data, and clinical outcomes were collected. Secondary exploratory subgroup analysis was performed according to the postoperative facet joint preservation rate. Patients were divided into group A (preservation rate 75%–100%, n = 39) and group B (preservation rate 50%–75%, n = 48). Demographic, perioperative, imaging, and clinical outcomes of the two groups were compared.

Results

The mean age of the patients was 65.83 ± 7.22 years, and the surgical segments were mainly at L4/5; the mean operation time was 85.39 ± 7.22 min, the mean hemoglobin reduction was 13.46 ± 3.40 g/L, the mean hospital stay was 5.31 ± 2.81 days. There were no significant changes in imaging parameters at the final follow-up compared with preoperative values. The intra-group comparison showed that low back pain VAS, leg pain VAS, and ODI scores at each postoperative follow-up time point were significantly lower than those preoperatively (P < 0.001), whereas low back pain VAS, leg pain VAS, and ODI scores at 1 year postoperatively were higher than those at 6 months postoperatively (P < 0.001). The postoperative complication rate was 13.8% (12/87). The excellent and good rate of modified MacNab criteria was 82.8% at the final follow-up. Secondary exploratory subgroup analysis revealed no statistically significant differences between groups A and B in baseline data, preoperative and final follow-up imaging parameters, low back pain VAS, leg pain VAS, ODI scores at each time point, postoperative complication rate, as well as the excellent and good rate of the modified MacNab criteria at final follow-up (P > 0.05). Only operation time in group B was longer than that in group A (P = 0.028).

Conclusion

For patients with mild-to-moderate LSS complicated with DLS, UBE can alleviate clinical symptoms. Based on static imaging findings, lumbar spine stability can be maintained postoperatively over a certain follow-up period. Therefore, UBE represents a viable therapeutic option in clinical practice. Nevertheless, further research is needed to assess longer-term clinical outcomes in the future.