Comparison of unilateral biportal endoscopic decompression and percutaneous endoscopic lumbar decompression for single-level degenerative lumbar spinal stenosis: a systematic review and meta-analysis.

BACKGROUND

Currently, both unilateral biportal endoscopic decompression (UBED) and percutaneous endoscopic lumbar decompression (PELD) recognized as effective treatments for degenerative lumbar spinal stenosis (DLSS). Nevertheless, there remains a divergence of opinion regarding the preferable operative procedure. Consequently, the meta-analysis aimed to evaluate and compare the effectiveness and adverse events associated with UBED and PELD in the treatment of DLSS.

METHODS

Multiple databases were thoroughly screened on the internet to identify studies focusing on clinical endpoints and complications of UBED versus PELD in the management of single-level DLSS. Visual analogue scale (VAS) scores and Oswestry Disability Index (ODI) were recorded to assess clinical outcomes. Additionally, perioperative findings and complications were documented for analysis. Meta-analyses were conducted using Stata MP 17.0 software.

RESULTS

A total of 14 studies involving 1222 participants were included in this analysis. The results indicated that UBED significantly reduced operative time, VAS scores for leg pain at three months postoperatively and ODI at the final follow-up (p < 0.05). Furthermore, UBED was associated with a significant increase in postoperative dural sac cross-sectional area compared to PELD (p < 0.05). No significant differences were observed between UBED and PELD concerning intraoperative blood loss, length of hospital stay, VAS scores for back pain, overall complication rates, or dural tear rates (p > 0.05).

CONCLUSION

Our evidence suggests that there is no significant difference between UBED and PELD regarding most outcomes. However, UBED may reduce operative time while providing superior decompression efficacy compared to PELD. Therefore, these findings indicate that UBED appears more effective than PELD in treating single-level DLSS. Further multi-center randomized controlled trials are necessary before definitive conclusions can be drawn.