Surgical Outcomes of Unilateral Biportal Endoscopy Versus Full Endoscopy for Lumbar Canal Stenosis: A Meta-Analysis.

Lumbar canal stenosis (LCS) is a common cause of chronic lower back pain in the elderly. Traditionally, open decompression surgery has a prolonged recovery, higher blood loss, and more complications. As a result, there remains no clear consensus on which of these minimally invasive spine surgery (MISS) techniques, including unilateral biportal endoscopy (UBE) and full endoscopy (FE), is the optimal technique for LCS treatment. A systematic review and meta-analysis were accomplished to compare the surgical results of UBE versus FE for lumbar canal stenosis in regard to surgical success, postoperative pain control, operative times, complication rates, and functional outcomes. Studies from 2024 were searched comprehensively in PubMed, Scopus, and other databases. Randomized controlled trials (RCTs) and experimental studies comparing UBE with FE were included. Surgical success rates, pain scores (visual analog scale (VAS)), recovery time, and complications were the key outcomes analyzed. Five studies (sample size: 32-163) were included. High surgical success and no significant difference in pain relief were demonstrated by both UBE and FE. UBE was associated with significantly quicker recovery times (odds ratio (OR): 0.54, 95% confidence interval (CI): 0.35-0.83, P = 0.01). The complication rates were lower with UBE compared with FE. Both techniques improved functional outcomes, but UBE had a slight advantage in recovery time. Both UBE and FE present effective treatments for LCS, and UBE is superior concerning recovery time. The choice of technique should be based on the patient's characteristics, and surgical goals should be tailored to each individual patient.