Comparative efficacy of unilateral biportal endoscopy and micro-endoscopic discectomy in the treatment of elderly patients with lumbar spinal stenosis

Abstract

Objective: Currently, the comparative clinical efficacy of unilateral biportal endoscopy (UBE) and microendoscopic discectomy (MED) in the treatment of elderly lumbar spinal stenosis (LSS) is unclear. This study compared the clinical advantages of UBE and MED.

Methodology: This retrospective study was conducted at Dalian Third People’s Hospital and included clinical data of 105 elderly LSS patients who underwent surgical treatment from March 2023 to July 2024. According to different surgical methods, patients were divided into the UBE group (n=48) and the MED group (n=57). The study compared baseline characteristics, perioperative indicators, and clinical outcomes at three days, one month, six months, and one year post procedure. Lower back and leg pain was assessed using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI).

Results: UBE was associated with a considerably shorter length of surgery, less intraoperative blood loss, and a shorter hospital stay (P < 0.05). There were no statistically significant differences in the VAS and ODI scores between the UBE and MED groups (P > 0.05). VAS scores and ODI scores markedly improved in both groups at all postoperative time points (P < 0.05). UBE resulted in a significantly lower overall complication rate than MED (P<0.05).

Conclusions: UBE and MED demonstrate comparable clinical efficacy in relieving pain and improving function in elderly patients with LSS. However, UBE exhibits significant advantages in perioperative safety and overall complication rates.