{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:53:42Z","timestamp":1790913222587,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Conventional endoscopic decompression for double\u2010segment lumbar spinal stenosis (LSS) generally requires multiple portals and incisions, which may increase tissue disruption, procedural complexity, and radiation exposure. Evidence is limited on whether two adjacent levels can be adequately decompressed through a single\u2010incision, non\u2010coaxial approach. To compare the clinical efficacy, perioperative outcomes, and safety of double\u2010segment arthroscopic\u2010assisted uni\u2010portal spinal surgery (DS\u2010AUSS\/DS\u2010UNSES) with double\u2010segment unilateral biportal endoscopy (DS\u2010UBE) for unilateral laminotomy with bilateral decompression (ULBD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective comparative study included 103 patients who underwent double\u2010segment ULBD between January 2022 and January 2024 (DS\u2010AUSS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955; DS\u2010UBE,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948). Visual Analog Scale (VAS), Oswestry Disability Index (ODI), anterior\u2013posterior diameter of the canal, Schizas stenosis grade, modified MacNab criteria, perioperative parameters, and complications were evaluated. Independent\u2010samples\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests, Chi\u2010square or Fisher exact tests, and mixed\u2010design repeated\u2010measures analysis of variance with Bonferroni\u2010corrected post hoc comparisons were used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both groups showed significant postoperative improvements in VAS, ODI, and stenosis grade (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Compared with DS\u2010UBE, DS\u2010AUSS produced lower VAS scores at postoperative Day 3 (mean difference, \u22120.75; 95% CI, \u22121.08 to \u22120.42;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and lower ODI at 3\u2009months (mean difference, \u22125.53%; 95% CI, \u22128.84 to \u22122.22;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). DS\u2010AUSS also reduced operative time (mean difference, \u221216.94\u2009min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), intraoperative blood loss (median difference, \u221212.0\u2009mL;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024), postoperative drainage (mean difference, \u221216.14\u2009mL;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), fluoroscopy frequency (median difference, \u22122.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and hospital stay (mean difference, \u22121.18\u2009days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). At 12\u2009months, Grade A\/B stenosis improvement (96.4% vs. 93.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.490) and MacNab excellent\/good rates (92.73% in both groups;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.633) were comparable. Overall complication rates were 7.3% and 14.6%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.350).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DS\u2010AUSS achieved 1\u2010year clinical and radiographic outcomes comparable to DS\u2010UBE while improving perioperative efficiency, reducing tissue trauma and fluoroscopy exposure, and accelerating early recovery. It is a feasible minimally invasive option for selected patients with double\u2010segment LSS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70413","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:57:36Z","timestamp":1787727456000},"page":"2142-2152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Retrospective Comparative Study on Arthroscopic\u2010Assisted Uni\u2010Portal Spinal Surgery (\n                    <scp>AUSS<\/scp>\n                    \/\n                    <scp>UNSES<\/scp>\n                    ) Versus Unilateral Biportal Endoscopy for Double\u2010Segment Lumbar Spinal Stenosis"],"prefix":"10.1111","volume":"18","author":[{"given":"Zhide","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Spine Surgery Second Affiliated Hospital of Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"En","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine The First Affiliated Hospital of Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyuan","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery Second Affiliated Hospital of Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XiangLong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery Second Affiliated Hospital of Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yabo","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery Second Affiliated Hospital of Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfeng","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery Second Affiliated Hospital of Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2013.0613"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010003\u20100612\u20101"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010020\u201006339\u20101"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.04.079"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.11.014"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wnsx.2020.100077"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219871918"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/9074257"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.22067"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9040402"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201086106\u20108"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010024\u201004621\u20102"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2024.07.003"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010025\u201005779\u2010z"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632\u2010198205000\u201000004"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632\u2010200011150\u201000017"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181d359bd"},{"key":"e_1_2_13_19_1","first-page":"891","article-title":"Negative Disc Exploration. An Analysis of the Causes of Nerve\u2010Root Involvement in Sixty\u2010Eight Patients","volume":"53","author":"Macnab I.","year":"1971","journal-title":"Journal of Bone & Joint Surgery"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010264.pub2"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620x.104b12.Bjj\u20102022\u20101131"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000039763"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201089179\u20107"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/03000605241312828"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010025\u201008551\u2010w"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701\u2010019\u201004162\u20102"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.12659\/msm.944018"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70413","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.70413","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:58:19Z","timestamp":1790909899000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":26,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/os.70413"],"URL":"https:\/\/doi.org\/10.1111\/os.70413","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"2026-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}