A meta-analysis of clinical effects of microscopic unilateral laminectomy bilateral decompression (ULBD) versus biportal endoscopic ULBD for lumbar canal stenosis

Guang-Xun Lin; Zhi-Kang Yao; Chen Xin; Jin-Sung Kim; Chien-Min Chen; Bao-Shan Hu

doi:10.3389/fsurg.2022.1002100

A meta-analysis of clinical effects of microscopic unilateral laminectomy bilateral decompression (ULBD) versus biportal endoscopic ULBD for lumbar canal stenosis

Front Surg. 2022 Sep 23:9:1002100. doi: 10.3389/fsurg.2022.1002100. eCollection 2022.

Authors

Guang-Xun Lin^{1

2}, Zhi-Kang Yao³, Chen Xin¹, Jin-Sung Kim⁴, Chien-Min Chen^{5

6

7}, Bao-Shan Hu^{1

2}

Affiliations

¹ Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
² The Third Clinical Medical College, Fujian Medical University, Fuzhou, China.
³ Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
⁴ Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
⁵ Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
⁶ College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan.
⁷ School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

Osbjective: Several studies have shown that both microscopic unilateral laminotomy bilateral decompression (ULBD) and unilateral biportal endoscopic (UBE) ULBD are effective for treating lumbar canal stenosis (LCS). However, there are different viewpoints as to which surgical technique is superior. Therefore, this meta-analysis investigated the clinical efficacy and side effects of microscopic ULBD and UBE ULBD for treating LCS.

Methods: To identify relevant studies describing the clinical outcomes and complication rates of microscopic ULBD and UBE ULBD for LCS, several databases were systematically searched in the Internet. The visual analog scale score for back and leg pain and the Oswestry Disability Index were used to assess clinical outcomes. Furthermore, data about perioperative outcomes and complications were documented.

Results: In total, six studies with 450 participants were included in this meta-analysis. The UBE ULBD was found to be superior to microscopic ULBD in terms of efficacy against early postoperative back and leg pain. However, there was no significant difference between the two procedures in terms of final clinical outcomes and complications. In addition, compared with microscopic ULBD, UBE ULBD was associated with a significant reduction in the length of hospital stay and C-reactive protein levels 2 days after surgery.

Conclusion: UBE ULBD and microscopic ULBD for the treatment of LCS were similar in terms of final clinical outcomes and complications. However, UBE ULBD has several advantages over microscopic ULBE, including a shorter hospital stay and faster alleviation of postoperative back and leg pain.

Keywords: biportal endoscopic spinal surgery; lumbar canal stenosis; microscopic surgery; unilateral biportal endoscopic; unilateral laminotomy bilateral decompression.