{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T07:04:51Z","timestamp":1779433491346,"version":"3.53.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"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>Purpose<\/jats:title>\n                    <jats:p>To compare the clinical efficacy and perioperative outcomes of arthroscopy-assisted uniportal spinal surgery (AUSS) and unilateral biportal endoscopy (UBE) for the treatment of adjacent two-segment lumbar disc herniation (AT-LDH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, we analyzed the data of 59 patients with AT-LDH admitted to our department between January 2020 and May 2025. Of these, 33 patients underwent AUSS and 26 underwent UBE. The primary outcome measures were the visual analog scale (VAS) for low back and leg pain and Oswestry disability index (ODI). Secondary outcomes included operative time, number of intraoperative fluoroscopies, incision length, length of hospital stay, perioperative hemoglobin change, complications, facet joint preservation, and serum inflammatory markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both the AUSS and UBE groups exhibited significant postoperative improvements in VAS and ODI compared with baseline (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). No significant between-group differences in clinical efficacy were observed at any time point (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). The excellent-to-good rates were 87.9% for AUSS and 88.5% for UBE. No significant between-group differences in complication and facet joint preservation rates were found (AUSS: 6.1% vs. UBE: 7.7% and AUSS: 81.6% vs. UBE: 83.2%, respectively). However, the AUSS group showed shorter incision length and operative time, fewer fluoroscopic exposures, smaller postoperative hemoglobin decreases, and lower levels of inflammatory markers on postoperative day 3 (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both AUSS and UBE provided satisfactory short-term clinical outcomes for AT-LDH. AUSS offers advantages of reduced invasiveness, greater surgical efficiency, and lower inflammatory response, supporting its broader clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1825301","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:08:08Z","timestamp":1779430088000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative outcomes of arthroscopy-assisted uniportal spinal surgery vs. unilateral biportal endoscopy for adjacent two-segment lumbar disc herniation: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Cheng","family":"He","sequence":"first","affiliation":[{"name":"Department of Orthopedic, The 908th Hospital of Chinese People\u2019s Liberation Army Joint Logistic Support Force","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, The 908th Hospital of Chinese People\u2019s Liberation Army Joint Logistic Support Force","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, The 908th Hospital of Chinese People\u2019s Liberation Army Joint Logistic Support Force","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Xi\u2019an Jiaotong University Affiliated Honghui Hospital","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhilin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, Guangyuan Central Hospital","place":["Guangyuan, Sichuan, 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","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xigao","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, The Second Affiliated Hospital of Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangjun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, The 908th Hospital of Chinese People\u2019s Liberation Army Joint Logistic Support Force","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1016\/j.amjmed.2023.03.024","article-title":"Lumbar disc herniation: diagnosis and management","volume":"136","author":"ZZhang","year":"2023","journal-title":"Am J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1999","DOI":"10.1111\/os.14101","article-title":"The differences on the fatty infiltration of paraspinal muscles between single- and multiple-level intervertebral disc degeneration in patients with lumbar disc herniation","volume":"16","author":"Shen","year":"2024","journal-title":"Orthop Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.wneu.2022.11.029","article-title":"Prevalence of long-term low back pain after symptomatic lumbar disc herniation","volume":"170","author":"Wong","year":"2023","journal-title":"World Neurosurg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1016\/j.spinee.2023.12.009","article-title":"Full-endoscopic versus microscopic spinal decompression for lumbar spinal stenosis: a systematic review & meta-analysis","volume":"24","author":"Chin","year":"2024","journal-title":"Spine J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"3517","DOI":"10.1177\/21925682251339999","article-title":"Uniportal versus biportal endoscopic decompression for the treatment of lumbar spinal stenosis: a systematic review and updated meta-analysis","volume":"15","author":"Lobo","year":"2025","journal-title":"Global Spine J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.3390\/diagnostics15081021","article-title":"Effectiveness and safety of transforaminal spinal endoscopy: analysis of 1000 clinical cases","volume":"15","author":"Tornatore","year":"2025","journal-title":"Diagnostics (Basel)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"4415","DOI":"10.1007\/s00586-025-08998-4","article-title":"Comparison of the efficacy of arthroscopic-assisted uni-portal spinal surgery and percutaneous endoscopic lumbar discectomy in the treatment of far lateral lumbar disc herniation: a retrospective controlled study","volume":"34","author":"Li","year":"2025","journal-title":"Eur Spine J"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e39763","DOI":"10.1097\/MD.0000000000039763","article-title":"Arthroscopic-assisted uni-portal ligament flavum sparing bone anchoring annular suture technique for lumbar disc herniation: a case report and literature review","volume":"103","author":"Xia","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1186\/s13018-025-05779-z","article-title":"Clinical efficacy of AUSS\/UNSES-TLIF in the treatment of single-segment degenerative lumbar spinal stenosis: a retrospective study","volume":"20","author":"Liu","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"124026","DOI":"10.1016\/j.wneu.2025.124026","article-title":"Evaluation of hidden blood loss and clinical outcomes of arthroscopy-assisted uni-portal spinal surgery for lumbar disc herniation with lateral recess stenosis","volume":"198","author":"Zhou","year":"2025","journal-title":"World Neurosurg"},{"key":"B11","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":"B12","doi-asserted-by":"publisher","first-page":"454","DOI":"10.5694\/mja11.10992","article-title":"Practical neurology\u20143: back pain and leg weakness","volume":"195","author":"Kleinig","year":"2011","journal-title":"Med J Aust"},{"key":"B13","first-page":"76","article-title":"Multi-level disc degeneration in young individuals-a prospective MRI study of 100 computer professionals","volume":"9","author":"Barani","year":"2018","journal-title":"EC Orthop"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta17190","article-title":"The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model","volume":"17","author":"Beynon","year":"2013","journal-title":"Health Technol Assess"},{"key":"B15","doi-asserted-by":"publisher","first-page":"TC04","DOI":"10.7860\/JCDR\/2015\/11927.5761","article-title":"MRI Evaluation of lumbar disc degenerative disease","volume":"9","author":"Suthar","year":"2015","journal-title":"J Clin Diagn Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"S43","DOI":"10.1097\/BRS.0b013e31822ef700","article-title":"Degenerative magnetic resonance imaging changes in patients with chronic low back pain: a systematic review","volume":"36","author":"Chou","year":"2011","journal-title":"Spine (Phila Pa 1976)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e72224","DOI":"10.7759\/cureus.72224","article-title":"A comparative study between selective nerve root blocks versus caudal epidural steroid injection in the management of lumbar radiculopathy","volume":"16","author":"Kale","year":"2024","journal-title":"Cureus"},{"key":"B18","doi-asserted-by":"publisher","first-page":"3000605251351726","DOI":"10.1177\/03000605251351726","article-title":"Uni-portal non-coaxial spinal endoscopic surgery combined with annulus fibrosus suture technique for lumbar disc herniation: case series","volume":"53","author":"Li","year":"2025","journal-title":"J Int Med Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1186\/s13018-025-06088-1","article-title":"Comparison of short-term clinical outcomes and muscle injury in patients with lumbar spinal stenosis undergoing arthroscopic-assisted uni-portal spinal surgery, unilateral biportal endoscopic surgery, and percutaneous interlaminar lumbar discectomy: a six-month follow-up","volume":"20","author":"Zhou","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"B20","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.jor.2024.07.003","article-title":"Arthroscopic-assisted uni-portal spinal surgery combined with modified unilateral laminotomy with bilateral decompression for the treatment of lumber epidural lipomatosis: case report and new therapeutic method","volume":"58","author":"Li","year":"2024","journal-title":"J Orthop"},{"key":"B21","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1186\/s13018-024-04621-2","article-title":"Clinical effects of arthroscopic-assisted uni-portal spinal surgery and unilateral bi-portal endoscopy on unilateral laminotomy for bilateral decompression in patients with lumbar spinal stenosis: a retrospective cohort study","volume":"19","author":"Wang","year":"2024","journal-title":"J Orthop Surg Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2154","DOI":"10.1007\/s00586-024-08293-8","article-title":"Percutaneous endoscopic transforaminal discectomy and unilateral biportal endoscopic discectomy for lumbar disc herniation: a comparative analysis of learning curves","volume":"33","author":"Li","year":"2024","journal-title":"Eur Spine J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1186\/s13018-025-05591-9","article-title":"One-hole split endoscopy versus unilateral biportal endoscopy for lumbar degenerative disease: a systematic review and meta-analysis of clinical outcomes and complications","volume":"20","author":"Deng","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"B24","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1177\/2192568220941446","article-title":"Dural injury in unilateral biportal endoscopic spinal surgery","volume":"11","author":"Lee","year":"2021","journal-title":"Global Spine J"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e944018","DOI":"10.12659\/MSM.944018","article-title":"Comprehensive analysis of UBE-related complications: prevention and management strategies from 4685 patients","volume":"30","author":"Yang","year":"2024","journal-title":"Med Sci Monit"},{"key":"B26","doi-asserted-by":"publisher","first-page":"790","DOI":"10.31616\/asj.2019.0297","article-title":"Risk factors and options of management for an incidental dural tear in biportal endoscopic spine surgery","volume":"14","author":"Kim","year":"2020","journal-title":"Asian Spine J"},{"key":"B27","doi-asserted-by":"publisher","first-page":"985","DOI":"10.4055\/cios24189","article-title":"The effects of different coronal plane angulations during foraminoplasty on lumbar stability: a combined clinical and biomechanical study","volume":"17","author":"Wu","year":"2025","journal-title":"Clin Orthop Surg"},{"key":"B28","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1007\/s10237-025-01936-9","article-title":"A quantitative review of finite element-based biomechanics of lumbar decompression surgery","volume":"24","author":"Foltz","year":"2025","journal-title":"Biomech Model Mechanobiol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"123427","DOI":"10.1016\/j.wneu.2024.11.010","article-title":"Anatomic surface measurement of the lumbar laminae for safely resection during percutaneous endoscopic surgery: a computed tomography-based 3-dimensional morphometric study","volume":"194","author":"Wang","year":"2025","journal-title":"World Neurosurg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1825301\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:08:09Z","timestamp":1779430089000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1825301\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":29,"alternative-id":["10.3389\/fsurg.2026.1825301"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1825301","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"article-number":"1825301"}}