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

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. 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. 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). 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.