Comparison of postoperative outcomes, satisfaction, and complications between bilateral 3-portal endoscopy and unilateral biportal endoscopy in patients with lumbar spinal stenosis: A multicenter, retrospective, cohort study

Abstract

Background

Bilateral 3-portal endoscopy is a novel minimally decompression surgery based on the modification of unilateral biportal endoscopy, which achieves complete decompression through a bilateral approach for patients with lumbar spinal stenosis. This study tested the hypothesis that bilateral 3-portal endoscopy could improve clinical outcomes and satisfaction versus unilateral biportal endoscopy in these patients.

Methods

In this multicenter, retrospective, cohort study, 87 patients with lumbar spinal stenosis who received bilateral 3-portal endoscopy or unilateral biportal endoscopy were divided into bilateral 3-portal endoscopy (N = 35) and unilateral biportal endoscopy (N = 52) groups, respectively. Data on pain visual analog scale, Oswestry Disability Index, postoperative functional recovery by the Modified MacNab criteria, and patient self-reported satisfaction were retrieved. Complications were collected.

Results

Back pain visual analog scale score (P = .111) and leg pain visual analog scale score (P = .178) at approximately 3 months of follow-up (3 months ± 2 weeks) tended to decrease in the bilateral 3-portal endoscopy group versus the unilateral biportal endoscopy group, although there was no statistical significance. Oswestry Disability Index at approximately 3 months of follow-up was reduced in the bilateral 3-portal endoscopy group versus the unilateral biportal endoscopy group (P = .047). The percentage of good to excellent postoperative functional recovery at approximately 3 months of follow-up showed an increasing trend in the bilateral 3-portal endoscopy group versus the unilateral biportal endoscopy group, but it did not reach statistical significance (P = .239). Patient self-reported satisfaction at approximately 3 months of follow-up tended to elevate in the bilateral 3-portal endoscopy group versus the unilateral biportal endoscopy group, although there was no statistical significance (P = .126). Moreover, the incidence of complications did not vary between groups (P > .999).

Conclusion

Bilateral 3-portal endoscopy yields relatively better postoperative outcomes and higher patient satisfaction with comparable complications versus unilateral biportal endoscopy in patients with lumbar spinal stenosis.