A comparative analysis of unilateral biportal endoscopic and open laminectomy in multilevel lumbar stenosis.

Background: Approximately 103 million people across the globe suffer from symptomatic lumbar spinal stenosis, impacting their health and quality of life. The unilateral biportal endoscopic technique is effective for treating single-segment degenerative lumbar spinal stenosis and is seen as a viable alternative to traditional open lumbar laminectomy. However, research on the application of this technique for multilevel lumbar spinal stenosis remains lacking. Objective: To compare the clinical effects of unilateral biportal endoscopy (UBE) and open lumbar decompression (OLD) in the treatment of multilevel lumbar spinal stenosis (MLSS). Methods: This retrospective study was conducted from February 2019 to December 2023 and compared the outcomes of Multilevel UBE surgery to OLD. The included patients were divided into two groups, namely the UBE group ( Results: The surgical segments of the two groups primarily consisted of adjacent segments (UBE 78.6% vs. OLD 78.8%), with a higher proportion of bilateral decompression in the OLD group (UBE 24.4% vs. OLD 28.0%). Preoperative imaging evaluation indicated a higher prevalence of grade C (severe stenosis) compared to grade D (severe stenosis) in both groups (UBE 74.4% vs. OLD 72%). The OLD group exhibited significantly greater blood loss compared to the UBE group (147.63 ± 26.55 vs. 46.19 ± 25.25 mL, Conclusion: The unilateral biportal endoscopic technique was applied to treat multilevel lumbar spinal stenosis, demonstrating decreased intraoperative bleeding and lower postoperative muscle-related complications compared to open lumbar decompression. Furthermore, UBE was found to promote early mobilization.