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J Neurol Surg A Cent Eur Neurosurg 2022; 83(06): 523-534
DOI: 10.1055/s-0041-1739208
Original Article

Uniportal Full-Endoscopic versus Minimally Invasive Decompression for Lumbar Spinal Stenosis: A Meta-analysis

Yuqing Jiang
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
,
Jianjian Yin
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
,
Luming Nong    *
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
,
Nanwei Xu   *
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
› Author Affiliations Funding This study was supported by the Project of GUKEXUE (grant no. XK201603) General project of Jiangsu Provincial Department of health (H2019025), Six Talent Peaks Project, Jiangsu Provincial Finance Department (WSW-186) and Jiangsu Provincial Social Development Project (BE2020650).
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Abstract

Background In this study, we systematically analyze the effectiveness of the uniportal full-endoscopic (UPFE) and minimally invasive (MIS) decompression for treatment of lumbar spinal stenosis patients.

Methods We performed a systematic search in Medline, Embase, Europe PMC, PubMed, Web of Science, Cochrane databases, Chinese Biomedical Literature Database, China national knowledge infrastructure, and Wanfang Data databases for all relevant studies. All statistical analyses were performed using Review Manager version 5.3.

Results A total of 9 articles with 522 patients in the UPFE group and 367 patients in the MIS group were included. The results of the meta-analysis showed that the UPFE group had significantly better results in hospital stay time (mean difference [MD]: –2.05; 95% confidence interval [CI]: –2.87 to –1.23), intraoperative blood loss (MD: –36.56; 95% CI: –54.57 to –18.56), and wound-related complications (MD: –36.56; 95%CI: –54.57 to –18.56) compared with the MIS group, whereas the postoperative clinical scores (MD: –0.66; 95%CI: –1.79 to 0.47; MD: –0.75; 95%CI: –1.86 to 0.36; and MD: –4.58; 95%CI: –16.80 to 7.63), satisfaction rate (odds ratio [OR] = 1.24; 95%CI: 0.70–2.20), operation time (MD: 30.31; 95%CI: –12.55 to 73.18), complication rates for dural injury (OR = 0.60; 95%CI: 0.29–1.26), epidural hematoma (OR = 0.60; 95%CI: 0.29–1.26), and postoperative transient dysesthesia and weakness (OR = 0.73; 95%CI: 0.36–1.51) showed no significant differences between the two groups.

Conclusions The UPFE decompression is associated with shorter hospital stay time and lower intraoperative blood loss and wound-related complications compared with MIS decompression for treatment of lumbar spinal stenosis patients. The postoperative clinical scores, satisfaction rate, operation time, complication rates for dural injury, epidural hematoma, and postoperative transient dysesthesia and weakness did not differ significantly between two groups.

Keywords

meta-analysis - lumbar spinal stenosis - minimally invasive surgery - percutaneous uniportal full-endoscopic - bilateral decompression

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


Informed Consent

Informed consent was obtained from all individual participants included in the study.


* Co-first authors: Yuqing Jiang and Jianjian Yin.




Publication History

Received: 22 December 2020

Accepted: 23 April 2021

Article published online:
06 January 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
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