Objective This study aimed to evaluate the clinical and radiological outcomes of unilateral laminotomy for bilateral decompression (ULBD) using biportal endoscopic spinal surgery (BESS) in patients with central canal stenosis, with and without low-grade degenerative lumbar spondylolisthesis (DLS).
Methods A retrospective observational study was conducted on 170 patients who underwent BESS-ULBD between 2015 and 2018, with at least 2 years of follow-up. Patients were categorized into 2 groups: group A (68 patients) with central stenosis and low-grade DLS and group B (102 patients) with central stenosis alone. Clinical outcomes were assessed using the visual analogue scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and Modified MacNab criteria. Radiological assessments included sagittal translation measurements on dynamic flexion-extension radiographs.
Results Both groups significantly improved clinical outcomes at the final follow-up (p<0.05). Group A’s mean VAS scores improved from 3.8±2.4 to 1.9±2.0 for back pain and from 6.4±1.8 to 2.3±2.0 for leg pain. In group B, back pain improved from 3.9±2.5 to 1.7±1.9, and leg pain from 6.6±2.0 to 2.2±2.2. ODI scores also improved significantly in both groups. Radiological evaluation showed no significant changes in sagittal translation postoperatively, indicating preserved spinal stability. Both groups had comparable clinical outcomes, with no major complications reported.
Conclusion BESS-ULBD is a safe and effective minimally invasive option for managing central canal stenosis, with or without low-grade DLS. This technique provides substantial symptom relief, preserves spinal stability, and presents a promising alternative to more invasive fusion procedures in carefully selected patients.
Citations
Citations to this article as recorded by
Future Directions in the Treatment of Lumbar Spondylolisthesis Parikshit Juvekar, Susan Christopher, Zoher Ghogawala Neurosurgery Clinics of North America.2026; 37(1): 143. CrossRef
Trends in Utilization and Cost of Endoscopic Lumbar Decompression in Ambulatory Surgical Centers: A Nationwide Database Analysis From 2018 Through 2022 Mitchell K. Ng, Paul G. Mastrokostas, Leonidas E. Mastrokostas, Aaron B. Lavi, Luke B. Schwartz, Yasmine K. Eichbaum, Yulia Lee, Morgan Hitchner, William Green, Gregorio Baek, Joshua Mathew, Jonathan Dalton, Alec Giakas, Rajendra Singh, Afshin E. Razi, Ia Global Spine Journal.2026; 16(5): 2252. CrossRef
A Commentary on “International Practice Patterns in the Surgical Management of Primary Lumbar Disc Herniation: An AO Spine Cross-Sectional Study” Jin-Sung Kim Neurospine.2026; 23(1): 40. CrossRef
Response to the letter to the editor: Inconsistencies in obesity criteria: implications for systematic reviews on endoscopic spine surgery Wongthawat Liawrungrueang, Watcharaporn Cholamjiak, Peem Sarasombath, Yudha Mathan Sakti, Pang Hung Wu, Meng-Huang Wu, Yu-Jen Lu, Lo Cho Yau, Zenya Ito, Sung Tan Cho, Dong-Gune Chang, Kang Taek Lim Asian Spine Journal.2026; 20(1): 211. CrossRef
Targeted Decompression Under Local Anesthesia versus Extensive Decompression Under General Anesthesia for Octogenarians with Lumbar Degenerative Diseases: A Real-World Propensity Score-Matched Analysis Hang Zhang, Huili Cai, Yunzhong Cheng, Xuelin Li, Yang Liu, Fengping Liu, Jingchuan Sun, Haidan Chen Clinical Interventions in Aging.2026; Volume 21: 1. CrossRef
Application of minimally invasive decompression interventions for the surgical treatment of degenerative lumbar spondylolysthesis P. Remov, A. Babkin, S. Zalepugin, A. Mazurenko, S. Jurchenko, A. Malashenko, A. Kartyzhova, Yu. Aniskevich, D. Sackevich Healthcare.2026; (5): 4. CrossRef
Advancing Endoscopic Decompression in Degenerative Lumbar Spondylolisthesis – A Commentary on “Biportal Endoscopic Decompression for Degenerative Lumbar Spondylolisthesis With Stenosis” Jin-Sung Kim Neurospine.2025; 22(2): 566. CrossRef
Clinical outcomes of navigation-assisted versus fluoroscopy-guided UBE-ULBD in single-level lumbar spinal stenosis: a retrospective study Shi-Jie Liu, Si-Yuan Yao, Yao Zhang, Wan-Cheng lin, Li-Xiang Ding, Ji-Peng Song BMC Surgery.2025;[Epub] CrossRef
Objective Full endoscopic cervical surgery (FECS) is an evolving minimally invasive approach for treating cervical spine disorders. This systematic review synthesizes current evidence on the clinical outcomes and patient perspectives associated with FECS, specifically evaluating its safety, efficacy, and overall patient satisfaction.
Methods A systematic search of the PubMed/MEDLINE, Cochrane Library, Embase, and Web of Science databases was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies published between January 2000 and September 2024 that reported on clinical outcomes or patient perspectives related to FECS were included. Risk of bias was assessed using the ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) tool and the Cochrane Risk of Bias tool. Inclusion criteria encompassed randomized controlled trials, prospective cohort studies, retrospective studies, and observational studies focused on adult populations undergoing FECS for cervical spine surgery.
Results The final synthesis included 30 studies. FECS was associated with significant reductions in both cervical and radicular pain, as well as meaningful functional improvements, measured by standardized clinical scales such as the Neck Disability Index and visual analogue scale. Patient satisfaction rates were consistently high, with most studies reporting satisfaction exceeding 85%. Complication rates were low, primarily involving transient neurological deficits that were typically resolved without the need for further intervention. Nonrandomized studies generally presented a moderate risk of bias due to confounding and selection, whereas randomized controlled trials exhibited a low risk of bias.
Conclusion FECS is a safe and effective minimally invasive surgical option for cervical spine disorders associated with substantial pain relief, functional improvement and high levels of patient satisfaction.
Citations
Citations to this article as recorded by
Response to the letter to the editor: Inconsistencies in obesity criteria: implications for systematic reviews on endoscopic spine surgery Wongthawat Liawrungrueang, Watcharaporn Cholamjiak, Peem Sarasombath, Yudha Mathan Sakti, Pang Hung Wu, Meng-Huang Wu, Yu-Jen Lu, Lo Cho Yau, Zenya Ito, Sung Tan Cho, Dong-Gune Chang, Kang Taek Lim Asian Spine Journal.2026; 20(1): 211. CrossRef
Full-Endoscopic Posterior Cervical Foraminotomy and Discectomy for Cervical Disc Hernia With Unilateral Radiculopathy Idris Gurpinar, Mehmet Yigit Akgun, Furkan Almas, Ozkan Ates Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 149. CrossRef
Clinical and Functional Outcomes of Posterior Endoscopic Decompression for Symptomatic Cervical Disc Herniation Adam Mahendra Teja, Muhammed Anzar, Cheol Wung Park Cureus.2026;[Epub] CrossRef
Ultrasound-guided brachial plexus hydrodissection combined with acupotomy release for the treatment of cervical spondylotic radiculopathy: a multicenter retrospective study Xiang Shang, Guo-Rui Luan, Yang-Chun Song, Fen Zhang, San-Bing Wu, Kai Geng, Hou-Shan Fang, Wei Wei, Zhen-Ya Wang, Han-Qing Zhao, Yong-Hui Yang, De-Hong Meng Frontiers in Aging Neuroscience.2026;[Epub] CrossRef
Current Trends and Future Directions in Lumbar Spine Surgery: A Review of Emerging Techniques and Evolving Management Paradigms Gianluca Galieri, Vittorio Orlando, Roberto Altieri, Manlio Barbarisi, Alessandro Olivi, Giovanni Sabatino, Giuseppe La Rocca Journal of Clinical Medicine.2025; 14(10): 3390. CrossRef
Navigated Minimally Invasive Cervical and Cervicothoracic Fixation: A Technical Note on Surgical Technique and Proposed Classification Spyridon Komaitis, Konstantinos Zygogiannis, Sotirios Karatzoglou, Dimitrios Klitsinikos, Dritan Pasku, Khalid Salem Cureus.2025;[Epub] CrossRef
First
Prev
