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World Neurosurg. 2019 Feb 21. pii: S1878-8750(19)30449-8. doi: 10.1016/j.wneu.2019.02.038. [Epub ahead of print]

A systematic review of unilateral bi-portal endoscopic spinal surgery: preliminary clinical results and complications.

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Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Department of Orthopaedic Surgery, The General Hospital of Chinese People's Liberation Army (301 hospital), Beijing, China.
Spine unit, Department of Orthopaedics, Queen Savang Vadhana Memorial Hospital, Sriracha, Chonburi, Thailand.
Department of Neurosurgery, Daejeon Woori Spine Hospital, Daejeon, South Korea.
Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, South Korea.
Department of Neurosurgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, South Korea.
Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea. Electronic address:



Unilateral bi-portal endoscopic spine surgery (UBE) for the treatment of lumbar spinal diseases has achieved favorable results. In this systematic review, we summarized the technical nuances, surgical outcomes, and complications of UBE.


A systematic review of the literature published up to June 2018 was performed. Published studies related to UBE were identified through searching the PubMed database. The outcomes measured included operative time, hospital stay, complications, visual analogue scale (VAS), Oswestry disability index (ODI), and the Macnab criteria.


A total of 556 patients and 679 levels were collected from the selected 11 studies. The mean follow-up was 15.2 months, the mean operative time was 81.3 minutes, and the mean length of hospital stay was 4.4 days. The mean overall complication rate was 6.7% (ranging from 0% to 13.8%). The mean VAS score for leg pain decreased from preoperative 7.9 to 1.9 at final follow-up visit and the mean VAS score for back pain decreased from 5.7 to 1.8. The mean ODI significantly improved from preoperative 63.7 to 18.6 at the final follow-up. The average satisfied outcome (excellent/good; based on Macnab criteria) was 84.3% (range, 75.35-95%). There were similar results between UBE for the treatment of lumbar disc herniation and stenosis, including operative time, length of hospital stay, complications, and satisfaction rate.


Although the existing studies are limited to small size cohorts and short-term follow-up, based on the given preliminary results and experiences of current studies, UBE may be a feasible option for lumbar spinal surgery.


bi-portal; endoscopic spine decompression; endoscopic spine discectomy; endoscopic spine laminectomy; spinal endoscopy


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