Single channel Delta endoscopic decompression for single segment lumbar spinal stenosis: clinical outcomes and independent predictors of mid-term recovery

Background Lumbar Spinal Stenosis (LSS) is a common cause of low back and leg pain in middle-aged and elderly individuals, and traditional open surgery is highly invasive. As an emerging minimally invasive technique, the efficacy and prognostic factors of single-channel Delta endoscopy in single-segment LSS remained to be clarified.Objective To evaluate the clinical efficacy of single-channel Delta endoscopy in the treatment of single-segment LSS and to analyze the risk factors affecting postoperative functional recovery.Methods A retrospective analysis was conducted on 125 patients with single-segment LSS who underwent this surgery fro the m 1 January 2022, to 31 October 2024. Efficacy was assessed using Visual Analog Scale (VAS), the Oswestry Disability Index (ODI), the Japanese Orthopaedic Association (JOA) score, and modified MacNab criteria. Risk factors were identified through univariate and multivariate Logistic regression analyses.Results Postoperative VAS, ODI, and JOA scores of all patients improved significantly compared to preoperative scores (p < 0.001). The excellent-to-good rate according to the modified MacNab criteria at 12 months post-surgery was 93.6% (117/125), and the maximum pain-free walking distance increased significantly (p < 0.001). The complication rate was 13.60%. Multivariate analysis showed that prolonged preoperative symptom duration, the responsible segment at L5/S1, and comorbid diabetes were independent risk factors affecting the 12-month postoperative efficacy (p < 0.05).Conclusion Single-channel Delta endoscopy was safe and effective for treating single-segment LSS, with a high mid-term clinical excellent-to-good rate. Prolonged preoperative symptom duration, L5/S1 segment stenosis, and comorbid diabetes were independent risk factors for poor postoperative functional recovery. Clinicians should strengthen perioperative management for such patients.