ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Dual-media spinal endoscopy versus unilateral biportal endoscopy for single-level degenerative lumbar spinal stenosis: a comparative study of mid-term outcomes.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare the clinical and radiographic outcomes of dual-media spinal endoscopy (DMSE), a single-portal endoscopic system allowing flexible air-water switching, with unilateral biportal endoscopy (UBE) in the treatment of single-level degenerative lumbar spinal stenosis (DLSS).
methodsA retrospective analysis was performed on 105 patients diagnosed with single-level DLSS who underwent either DMSE (n = 48) or UBE (n = 57) between January 2023 and June 2024. Visual Analogue Scale (VAS) scores for back and leg pain and Japanese Orthopaedic Association (JOA) scores were recorded preoperatively and at 3 days, 1, 3, 6, and 12 months postoperatively. Radiographic parameters included facet resection rate, dural sac expansion, and decompression ratio. Serum creatine kinase (CK) changes and perioperative complications were also evaluated.
resultsBoth groups demonstrated significant improvements in low-back pain, leg pain, and JOA scores from 1 month through 12 months postoperatively (all p < 0.001). Unadjusted between-group differences in back-pain VAS (p = 0.034) and leg-pain VAS (p = 0.023) at 12 months did not remain statistically significant after Holm adjustment (adjusted p = 0.170 and 0.115, respectively).The fluoroscopy frequency was significantly lower in the DMSE group than in the UBE group(4 vs. 8 ; p < 0.001). The facet resection rate was significantly higher in DMSE (28.6 ± 13.7%) than in UBE (20.3 ± 12.1%; p = 0.001), and postoperative serum CK elevation was greater in DMSE (p = 0.010). Complication rates did not differ significantly between groups (2.1% vs. 1.8%; p > 0.05).
conclusionsBoth DMSE and UBE appear to be safe and effective minimally invasive procedures for patients with single-level DLSS, with generally comparable short- to mid-term clinical outcomes. DMSE was associated with lower fluoroscopy frequency but greater facet resection, whereas UBE showed lower early postoperative CK elevation. These findings suggest different perioperative and technical profiles rather than clear overall superiority of either technique.
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