Clinical and imaging study of unilateral biportal endoscopy in lumbar revision surgery

To describe the surgical technique and evaluate the preliminary clinical outcomes of Unilateral Biportal Endoscopy (UBE) for lumbar revision surgery. This retrospective case series included 11 patients who underwent lumbar revision surgery using the UBE technique between 2023 and 2024. Visual Analogue Scale (VAS) scores for leg pain and Oswestry Disability Index (ODI) scores were recorded preoperatively and postoperatively to assess clinical improvement. Perioperative parameters, including operative time, blood loss, and complications were documented. Clinical outcomes were categorized using the MacNab criteria at the 6-month follow-up. Data were analyzed using descriptive statistics and presented as medians with interquartile ranges (IQR). All surgical procedures were completed successfully without intraoperative neural injury. The median operative time was 96.0 min (IQR: 79.0–111.5), and the median intraoperative blood loss was 49.0 ml (IQR: 40.0–56.5). No postoperative complications, such as infection or dural tears, were observed. At the 6-month follow-up, the median leg pain VAS score decreased substantially from 7.0 (IQR: 6.0–8.5) preoperatively to 2.0 (IQR: 1.0–2.0). Similarly, the median ODI score improved from 66.0 (IQR: 58.0–74.0) to 30.0 (IQR: 27.0–33.0). According to the MacNab criteria, 90.9% of patients achieved excellent or good outcomes. Preliminary findings suggest that the UBE technique is a feasible and safe minimally invasive option for lumbar revision surgery. The procedure achieved satisfactory early clinical outcomes with manageable perioperative trauma. Further studies with larger cohorts and longer follow-up are warranted to validate these initial observations.