The use of conventional uniportal spinal endoscopic surgery for lumbar spinal stenosis may be limited by technical difficulties and a narrow field of view. The purpose of this study is to describe the biportal percutaneous endoscopic decompression (PBED) technique for lumbar spinal stenosis and the analysis of post-operative clinical results. The results of this study state that, from a surgical point of view, biportal percutaneous endoscopy is very similar to microscopic spinal surgery, allowing good visualization of the contralateral medial sublaminar and foraminal areas. The authors suggest that PBED, which is a minimally invasive procedure, is an alternative treatment option for degenerative lumbar stenosis.

Minimally invasive spinal surgery can minimize damage to normal anatomical structures. Recently, fully endoscopic spinal surgery has been attempted for lumbar fusion surgery. In this study, the authors performed a unilateral biportal percutaneous endoscopic (UBE) technique as a minimally invasive surgery for lumbar fusion. The aim of this study is to present the fully endoscopic UBE lumbar fusion (LIF) technique and to analyze the clinical outcomes. This study shows that fully endoscopic LIF with the UBE technique can represent a minimally invasive alternative for the treatment of lumbar degenerative disease.

This study retrospectively compared the clinical and radiological outcomes of biportal unilateral lumbar endoscopic fusion (ULIF) with those of conventional posterior lumbar fusion (PLIF). We selected 71 patients with ULIF (age, 68 ± 8 years) and 70 with PLIF (66 ± 9 years) for a lumbosacral segment followed for more than 1 year. The PLIF group demonstrated a significantly shorter intervention time and more transfusions than the ULIF group. The VAS for leg pain in both groups and for back pain in the ULIF group improved significantly at 1 week, while the VAS for back pain in the PLIF group improved significantly at 1 year. ODI scores improved at 1 year in both groups. Complication rates were not significantly different between the groups. Rates of fusion with certain and probable degrees were not significantly different between groups. However, the ULIF group had significantly (P = 0.013) fewer cases of definite fusion and more cases of probable fusion. It is therefore possible to conclude that ULIF is less invasive and just as effective as conventional PLIF in improving clinical outcomes and achieving fusion.