{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T10:52:24Z","timestamp":1793875944241,"version":"4.7.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Recently, minimally invasive unilateral laminotomy with bilateral decompression (ULBD) has been performed for lumbar stenosis using endoscopic approaches. The object of this retrospective study was to compare the clinical and radiological outcomes of three types of minimally invasive decompressive surgery: microsurgery, percutaneous uniportal endoscopic surgery, and percutaneous biportal endoscopic surgery.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n In the period from March 2016 to December 2017, minimally invasive ULBD was performed using microscopy, a uniportal endoscopic approach, or a biportal endoscopic approach to treat lumbar canal stenosis. Patients were classified into three groups based on the surgery they had undergone. The angle of medial facetectomy area and postoperative dural expansion were measured using MR images. The visual analog scale (VAS) score for leg and back pain, Oswestry Disability Index (ODI), operation time, and complications were assessed. Clinical and radiological parameters were compared among the three groups.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n There were 33 patients in the microscopy group, 37 in the biportal endoscopy group, and 27 in the uniportal endoscopy group. Preoperatively stenotic dural areas were significantly expanded in each of the three groups after surgery (p < 0.05). Mean dural expansion in the uniportal endoscopy group was significantly lower than that in the microscopy or biportal endoscopy group (p < 0.05). The mean angle of the facetectomy in the biportal endoscopic group was significantly lower than that in the microscopic group or uniportal endoscopic group (p < 0.05). On the 1st day after surgery, the VAS score for back pain was significantly higher in the microscopic group than in the uniportal or biportal endoscopic group (p < 0.05). However, there were no significant differences in the VAS score for back pain, VAS score for leg pain, or ODI at the final follow-up among the three groups (p > 0.05).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Although radiological results were different among the three groups of patients, postoperative clinical outcomes were significantly improved after each type of surgery. The percutaneous biportal or uniportal endoscopic approach offers the advantage of reduced immediate postoperative pain. A percutaneous uniportal or biportal endoscopic lumbar approach may be effective for the treatment of lumbar central stenosis and an alternative to conventional microsurgical decompression.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2019.2.focus197","type":"journal-article","created":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T18:49:13Z","timestamp":1556909353000},"page":"E9","source":"Crossref","is-referenced-by-count":245,"title":["Comparative analysis of three types of minimally invasive decompressive surgery for lumbar central stenosis: biportal endoscopy, uniportal endoscopy, and microsurgery"],"prefix":"10.3171","volume":"46","author":[{"given":"Dong Hwa","family":"Heo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Chan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choon Keun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Expert Rev Med Devices","first-page":"605","article-title":"Percutaneous endoscopic decompression for lumbar spinal stenosis","volume":"11","author":"Ahn Y","year":"2014","unstructured":"Ahn Y: Percutaneous endoscopic decompression for lumbar spinal stenosis. Expert Rev Med Devices 11:605\u2013616, 201425033889"},{"key":"b2","series-title":"J Neurosurg Spine","first-page":"339","article-title":"Minimally invasive laminectomy for lumbar spinal stenosis in patients with and without preoperative spondylolisthesis: clinical outcome and reoperation rates","volume":"22","author":"Alimi M","year":"2015","unstructured":"Alimi M, Hofstetter CP, Pyo SY, Paulo D, H\u00e4rtl R: Minimally invasive laminectomy for lumbar spinal stenosis in patients with and without preoperative spondylolisthesis: clinical outcome and reoperation rates. 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Clin Spine Surg 30:E162\u2013E168, 201728323694"},{"issue":"4","key":"b4","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts","volume":"39","author":"Guha D","year":"2015","unstructured":"Guha D, Heary RF, Shamji MF: Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts. Neurosurg Focus 39(4):E9, 201526424349"},{"key":"b5","series-title":"World Neurosurg","first-page":"474","article-title":"Contralateral sublaminar endoscopic approach for removal of lumbar juxtafacet cysts using percutaneous biportal endoscopic surgery: technical report and preliminary results","volume":"122","author":"Heo DH","year":"2019","unstructured":"Heo DH, Kim JS, Park CW, Quillo-Olvera J, Park CK: Contralateral sublaminar endoscopic approach for removal of lumbar juxtafacet cysts using percutaneous biportal endoscopic surgery: technical report and preliminary results. World Neurosurg 122:474\u2013479, 201930458327"},{"key":"b6","series-title":"World Neurosurg","first-page":"e684","article-title":"Can percutaneous biportal endoscopic surgery achieve enough canal decompression for degenerative lumbar stenosis? 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J Orthop Surg Res 13:22, 201829386033"},{"key":"b11","series-title":"J Spinal Disord Tech","first-page":"281","article-title":"Bilateral operation of lumbar degenerative central spinal stenosis in full-endoscopic interlaminar technique with unilateral approach: prospective 2-year results of 74 patients","volume":"24","author":"Komp M","year":"2011","unstructured":"Komp M, Hahn P, Merk H, Godolias G, Ruetten S: Bilateral operation of lumbar degenerative central spinal stenosis in full-endoscopic interlaminar technique with unilateral approach: prospective 2-year results of 74 patients. 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Expert Rev Med Devices 11:605\u2013616, 201425033889"},{"key":"b2","series-title":"J Neurosurg Spine","first-page":"339","article-title":"Minimally invasive laminectomy for lumbar spinal stenosis in patients with and without preoperative spondylolisthesis: clinical outcome and reoperation rates","volume":"22","author":"Alimi M","year":"2015","unstructured":"Alimi M, Hofstetter CP, Pyo SY, Paulo D, H\u00e4rtl R: Minimally invasive laminectomy for lumbar spinal stenosis in patients with and without preoperative spondylolisthesis: clinical outcome and reoperation rates. J Neurosurg Spine 22:339\u2013352, 201525635635"},{"key":"b3","series-title":"Clin Spine Surg","first-page":"E162","article-title":"Assessment of paraspinal muscle cross-sectional area after lumbar decompression: minimally invasive versus open approaches","volume":"30","author":"Bresnahan LE","year":"2017","unstructured":"Bresnahan LE, Smith JS, Ogden AT, Quinn S, Cybulski GR, Simonian N, : Assessment of paraspinal muscle cross-sectional area after lumbar decompression: minimally invasive versus open approaches. 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J Orthop Surg Res 13:22, 201829386033"},{"key":"b11","series-title":"J Spinal Disord Tech","first-page":"281","article-title":"Bilateral operation of lumbar degenerative central spinal stenosis in full-endoscopic interlaminar technique with unilateral approach: prospective 2-year results of 74 patients","volume":"24","author":"Komp M","year":"2011","unstructured":"Komp M, Hahn P, Merk H, Godolias G, Ruetten S: Bilateral operation of lumbar degenerative central spinal stenosis in full-endoscopic interlaminar technique with unilateral approach: prospective 2-year results of 74 patients. J Spinal Disord Tech 24:281\u2013287, 201120975592"},{"key":"b12","series-title":"Pain Physician","first-page":"61","article-title":"Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study","volume":"18","author":"Komp M","year":"2015","unstructured":"Komp M, Hahn P, Oezdemir S, Giannakopoulos A, Heikenfeld R, Kasch R, : Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study. 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