Unilateral Biportal Endoscopic Decompression for Symptomatic Lumbar Stenosis Associated with Degenerative Scoliosis in Elderly Patients.

Abstract

This study was conducted to evaluate the results of unilateral biportal endoscopic (UBE) decompression in elderly patients with lateral recess/central canal stenosis associated adult scoliosis who have compensated deformities without significant instability. A retrospective analysis was conducted on 32 patients who underwent UBE decompression for adult scoliosis between January 2022 and December 2024. Preoperative and postoperative assessments included Numeric Rating Scale (NRS) for back and leg pain, Oswestry Disability Index (ODI), Core Outcome Measures Index (COMI), and Scoliosis Research Society-22 (SRS-22) questionnaires. Complication and re-operation rates were also recorded. During the specified period, 32 of the 89 patients with scoliosis patient underwent UBE surgery. In the long-term follow-up of the patients, statistically significant improvement was observed in leg pain NRS scores, ODI, and COMI scores. All patients were mobilized on the first postoperative day, and discharge occurred on average within 28 hours. Reoperation was required in 3 patients (9%), while complications developed in 2 patients (6%). UBE decompression surgery may be a surgical treatment option for selected elderly patients with degenerative scoliosis. Clinical improvement was observed in radicular leg pain and selected functional outcomes, whereas no significant improvement was observed in axial back pain or scoliosis-specific quality of life. Our findings should be interpreted cautiously, considering the published minimal clinically important difference threshold. Studies with longer follow-up periods and larger patient populations are required to confirm the sustainability of our findings.