E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Unilateral Biportal Endoscopy for Lumbar Disc Herniation and Spinal Stenosis: Clinical Outcomes and Complication Analysis
Ali Kaplan✉ ,
Mehmet İlker Özer ,
Nurullah Büyükgül ,
İlker Solmaz
Neurosurgery, Tokat Erbaa State Hospital; Neurosurgery, Sincan Research and Training Hospital, Department of Neurosurgery, Ankara, Türkiye; Neurosurgery, Private Practice
DOI: 10.5137/1019-5149.JTN.50151-25.4
Article in Press
Corresponding Author:
Ali Kaplan (alikaplan92@hotmail.com)
Abstract
Aim
Degenerative spinal diseases including lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS) are well-known factors which significantly impair quality of life. Unilateral biportal endoscopic (UBE) technique is an innovative minimally invasive method offering high-resolution visualization through two independent portals. The aim of this study was to evaluate clinical outcomes, complications, and pathological distribution in patients undergoing UBE surgery.
Material and Methods
This retrospective study included 127 patients with LDH and/or LSS who underwent UBE surgery between October 2024 and May 2025. Demographic and operative data were reviewed. Clinical outcomes were evaluated using Visual Analog Scale (VAS) scores at baseline, on postoperative Day 1, and at three months and using Oswestry Disability Index (ODI) scores at baseline and at three months. The primary outcome was the change in ODI from baseline to three months. Secondary outcomes included trajectories of VAS-leg/back, operative metrics, and complications.
Results
Of the patients, 58.3% were female and 41.7% were male with a mean age of 49.20±13.92 years. The mean operative time was 48.76±14.18 min, and 94.5% were discharged within one day. The most common pathology was pure disc herniation (63%), predominantly at the L4-L5 level (59.8%). Complication rates were dural tear in 3.9%, wound discharge in 2.4%, and recurrence in 3.2%. Statistically significant improvements in VAS and ODI scores were observed postoperatively (p<0.001). Moreover, minimum clinically important difference (MCID)-based responder rates were high for both disability and pain outcomes at three months, indicating that the improvements were also clinically meaningful.
Conclusion
The UBE technique is associated with shorter operative time and length of hospital stay. This finding supports its place as effective and safe minimally invasive treatment for LDH and LSS, facilitating rapid functional recovery and early discharge.
Degenerative spinal diseases including lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS) are well-known factors which significantly impair quality of life. Unilateral biportal endoscopic (UBE) technique is an innovative minimally invasive method offering high-resolution visualization through two independent portals. The aim of this study was to evaluate clinical outcomes, complications, and pathological distribution in patients undergoing UBE surgery.
Material and Methods
This retrospective study included 127 patients with LDH and/or LSS who underwent UBE surgery between October 2024 and May 2025. Demographic and operative data were reviewed. Clinical outcomes were evaluated using Visual Analog Scale (VAS) scores at baseline, on postoperative Day 1, and at three months and using Oswestry Disability Index (ODI) scores at baseline and at three months. The primary outcome was the change in ODI from baseline to three months. Secondary outcomes included trajectories of VAS-leg/back, operative metrics, and complications.
Results
Of the patients, 58.3% were female and 41.7% were male with a mean age of 49.20±13.92 years. The mean operative time was 48.76±14.18 min, and 94.5% were discharged within one day. The most common pathology was pure disc herniation (63%), predominantly at the L4-L5 level (59.8%). Complication rates were dural tear in 3.9%, wound discharge in 2.4%, and recurrence in 3.2%. Statistically significant improvements in VAS and ODI scores were observed postoperatively (p<0.001). Moreover, minimum clinically important difference (MCID)-based responder rates were high for both disability and pain outcomes at three months, indicating that the improvements were also clinically meaningful.
Conclusion
The UBE technique is associated with shorter operative time and length of hospital stay. This finding supports its place as effective and safe minimally invasive treatment for LDH and LSS, facilitating rapid functional recovery and early discharge.
Keywords
Unilateral biportal endoscopy
lumbar disc herniation
spinal stenosis
minimally invasive spinal surgery
outcomes