{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:33:41Z","timestamp":1792179221724,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82302780"],"award-info":[{"award-number":["82302780"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Conventional Unilateral Biportal Endoscopic (UBE) surgery usually requires general anesthesia (GA), which introduces additional risks to patients with significant medical comorbidities. This article explores the use of UBE decompression under local anesthesia (LA) in elderly patients with severe medical comorbidities treated at our institution, providing valuable clinical insights for the application of this technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on patients clinically diagnosed with lumbar spinal stenosis (LSS) at our center between November 2021 and March 2024, who underwent UBE decompression surgery under local LA. The data collected included demographics, visual analog scale (VAS) scores for leg pain, oswestry disability index (ODI), and modified Macnab grades. The UBE decompression procedure was divided into seven key steps, and intraoperative pain and the effectiveness of LA were assessed using patient self\u2010reported VAS scores at each step. Data comparisons between the preoperative, postoperative, and follow\u2010up time points were conducted using paired sample <jats:italic>t<\/jats:italic>\u2010tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen patients (5 males and 13 females) with an average age of 77.1\u2009\u00b1\u20095.0\u2009years were included in the study, with 83.3% (15 patients) having medical comorbidities. The average follow\u2010up period was 14.8\u2009\u00b1\u20097.9\u2009months. At 3\u2009months postoperative and final follow\u2010up, both VAS scores for leg pain (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and ODI scores (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) showed significant improvement. According to the modified Macnab criteria, outcomes were rated as excellent in 13 patients (72.2%), good in one (5.6%), fair in two (11.1%), and poor in one (5.6%), yielding an excellent\u2010good rate of 77.8%. None of the patients voluntarily requested surgery termination because of unbearable intraoperative pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For elderly patients with medical comorbidities, UBE decompression under LA is a viable and effective treatment option, yielding favorable clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70114","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T11:49:31Z","timestamp":1752580171000},"page":"2362-2370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unilateral Biportal Endoscopic Decompression for Degenerative Lumbar Spinal Stenosis Under Local Anesthesia in Elderly Patients with Medical Comorbidities"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7652-9945","authenticated-orcid":false,"given":"Haining","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuquan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangpeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingjia","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibo","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0638-4215","authenticated-orcid":false,"given":"Bin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9753-2692","authenticated-orcid":false,"given":"Qi","family":"Fei","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0288-9870","authenticated-orcid":false,"given":"Yuan\u2010Shun","family":"Lo","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, China Medical University Beigang Hospital China Medical University  Yunlin Taiwan"},{"name":"Division of Spine Surgery, Department of Orthopedic Surgery, China Medical University Hospital China Medical University  Taichung Taiwan"},{"name":"Spine Center China Medical University Hospital  Taichung City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3094-7014","authenticated-orcid":false,"given":"Xiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Beijing Friendship Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.5921"},{"issue":"10","key":"e_1_2_12_3_1","first-page":"1","article-title":"Artificial Discs for Lumbar and Cervical Degenerative Disc Disease\u2010Update: An Evidence\u2010Based Analysis","volume":"6","author":"Secretariat M. 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