{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:07:19Z","timestamp":1787162839271,"version":"build-2736575974"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unilateral biportal endoscopic (UBE) spine surgery is a minimally invasive procedure for treating lumbar disorders. Hidden blood loss (HBL) is easily ignored by surgeons because blood loss is less visible. However, there are limited studies on HBL in UBE spine surgery. This study aimed to evaluate HBL and its possible risk factors in patients undergoing UBE spine surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with lumbar disc herniation or lumbar spinal stenosis who underwent unilateral biportal endoscopic surgery between December 2020 and February 2022 at our hospital were retrospectively analyzed. Patient demographics, blood loss-related parameters, and surgical and radiological information were also collected. Pearson or Spearman correlation analysis was conducted to determine the association between clinical characteristics and HBL. Multivariate linear regression analysis was used to determine the independent risk factors for HBL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-two patients (17 males and 35 females) were retrospectively enrolled in this study. The mean total blood loss (TBL) volume was 434\u2009\u00b1\u2009212\u2005ml, and the mean HBL volume was 361\u2009\u00b1\u2009217\u2005ml, accounting for 77.9% of the TBL in patients who underwent UBE surgery. Multivariate linear regression analysis revealed that HBL was positively associated with operation time (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.040) and paraspinal muscle thickness at the target level (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The amount of HBL in patients undergoing UBE surgery should not be neglected. Operation time and paraspinal muscle thickness at the target level may be independent risk factors for HBL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2022.966197","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T01:28:05Z","timestamp":1660526885000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":29,"title":["Risk factors for hidden blood loss in unilateral biportal endoscopic lumbar spine surgery"],"prefix":"10.3389","volume":"9","author":[{"given":"Sijia","family":"Guo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haining","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linjia","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jisheng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Fei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"438","DOI":"10.21037\/jss.2020.03.08","article-title":"Unilateral biportal endoscopic decompression for degenerative lumbar canal stenosis","volume":"6","author":"Pao","year":"2020","journal-title":"J Spine Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"130","DOI":"10.14245\/ns.1938026.013","article-title":"Endoscopic treatment of extraforaminal entrapment of L5 nerve root (far out syndrome) by unilateral biportal endoscopic approach: technical report and preliminary clinical results","volume":"16","author":"Heo","year":"2019","journal-title":"Neurospine"},{"key":"B3","doi-asserted-by":"publisher","first-page":"602","DOI":"10.3171\/2015.7.SPINE15304","article-title":"Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: A technical note and preliminary clinical results","volume":"24","author":"Eum","year":"2016","journal-title":"J Neurosurg Spine"},{"key":"B4","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.wneu.2018.05.111","article-title":"Biportal endoscopic decompression of exiting and traversing nerve roots through a single interlaminar window using a contralateral approach: Technical feasibilities and morphometric changes of the lumbar canal and foramen","volume":"117","author":"Akbary","year":"2018","journal-title":"World Neurosurg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"325","DOI":"10.4055\/cios.2016.8.3.325","article-title":"Biportal endoscopic spinal surgery for recurrent lumbar disc herniations","volume":"8","author":"Choi","year":"2016","journal-title":"Clin Orthop Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/S0968-0160(00)00047-8","article-title":"How much blood is really lost in total knee arthroplasty? 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