Uniportal Endoscopic Approach for Multilevel Stenosis: A New Frontier in Minimally Invasive Spine Surgery

Objective: This retrospective observational study aimed to determine the safety and effectiveness of full endoscopy in the treatment of multilevel lumbar stenosis.Methods: All patients were aged over 18 and were treated for degenerative lumbar stenosis via full endoscopy. Anthropometric and surgical data were collected, as well as information on the hospital stay. Pain was measured using a visual analogue scale, and functional results were evaluated through the Oswestry Disability Index.Results: Forty-two patients (22 men and 20 women) were included. The mean patient age was 63.8±17.2 years. Thirty-five patients (83.3%) presented with involvement at 2 levels, whereas 7 (16.7%) had 3 affected levels. The mean operative time was 83.6±39.7 minutes, and the mean overall hospital stay stood at 17.6±8.9 hours. Radicular pain decreased from 7.5±1.8 points preoperatively to 0.4±0.9 points at 24 hours from surgery (p<0.001). Similarly, axial pain decreased from 3.4±2.5 points to 0.4±1 points (p<0.001). The Oswestry Disability Index fell from 49.6% preoperatively to 19.7% at 6 months of follow-up (p<0.001). As regards satisfaction with the procedure, 37 patients (88.1%) rated it as excellent and 100% of patients stated that they would undergo it again if required. Moreover, the proportion of patients on opioids was statistically significantly lower at 6 months postoperatively, diminishing from 30.8% (n=12) to 9.8% (n=4) (p<0.001).Conclusion: Full endoscopy is a safe and reliable technique for the treatment of central and foraminal multilevel lumbar stenosis, with fewer complications and a shorter hospital stay compared to traditional approaches.