Research progress of different minimally invasive spinal decompression in lumbar spinal stenosis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHU Tao ¹ , WU Diqiu ¹ ,  SHEN Mao ²

1. Guizhou Medical University, School of Clinical Medicine, Guiyang Guizhou, 550004, P. R. China;
2. Department of Orthopaedics, Affiliated Hospital of Guizhou Medical University, Guiyang Guizhou, 550004, P. R. China;

Corresponding author：

SHEN Mao, Email: 842477249@qq.com

Keywords：

Spinal decompression; lumbar spinal stenosis; unilateral biportal endoscopy; percutaneous endoscopic lumbar decompression

DOI：

10.7507/1002-1892.202303110

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review the application and progress of different minimally invasive spinal decompression in the treatment of lumbar spinal stenosis (LSS). Methods The domestic and foreign literature on the application of different minimally invasive spinal decompression in the treatment of LSS was extensively reviewed, and the advantages, disadvantages, and complications of different surgical methods were summarized. Results At present, minimally invasive spinal decompression mainly includes microscopic bilateral decompression, microendoscopic decompression, percutaneous endoscopic lumbar decompression, unilateral biportal endoscopy, and so on. Compared with traditional open surgery, different minimally invasive spinal decompression techniques can reduce the operation time, intraoperative blood loss, and postoperative pain of patients, thereby reducing hospital stay and saving treatment costs. Conclusion The indications of different minimally invasive spinal decompression are different, but there are certain advantages and disadvantages. When patients have clear surgical indications, individualized treatment plans should be formulated according to the symptoms and signs of patients, combined with imaging manifestations.

Citation： SHU Tao, WU Diqiu, SHEN Mao. Research progress of different minimally invasive spinal decompression in lumbar spinal stenosis. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(7): 895-900. doi: 10.7507/1002-1892.202303110 Copy

1.	Kalichman L, Cole R, Kim DH, et al. Spinal stenosis prevalence and association with symptoms: the Framingham Study. Spine J, 2009, 9(7): 545-550.
2.	Schneider MJ, Ammendolia C, Murphy DR, et al. Comparative clinical effectiveness of nonsurgical treatment methods in patients with lumbar spinal stenosis: A randomized clinical trial. JAMA Netw Open, 2019, 2(1): e186828. doi: 10.1001/jamanetworkopen.2018.6828.
3.	谢瑞, 于杰, 梁龙, 等. 腰椎管狭窄患者的手术和非手术治疗: 丹麦国家临床指南解读. 天津中医药, 2020, 37(1): 33-37.
4.	Mobbs RJ, Li J, Sivabalan P, et al. Outcomes after decompressive laminectomy for lumbar spinal stenosis: comparison between minimally invasive unilateral laminectomy for bilateral decompression and open laminectomy: clinical article. J Spine Surg, 2014, 21(2): 179-186.
5.	Fan N, Yuan S, Du P, et al. Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis. BMC Musculoskelet Disord, 2021, 22(1): 1041. doi: 10.1186/s12891-021-04940-z.
6.	Mobbs RJ, Phan K, Malham G, et al. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg, 2015, 1(1): 2-18.
7.	Försth P, Ólafsson G, Carlsson T, et al. A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med, 2016, 374(15): 1413-1423.
8.	Li H, Ou Y, Xie F, et al. Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study. J Orthop Surg Res, 2020, 15(1): 441. doi: 10.1186/s13018-020-01968-0.
9.	Hwa Eum J, Hwa Heo D, Son SK, et al. Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. J Neurosurg Spine, 2016, 24(4): 602-607.
10.	黎庆初, 谭斌, 刘雄文, 等. 显微内窥镜下应用改良器械减压治疗腰椎管狭窄症. 中国脊柱脊髓杂志, 2008, (5): 341-344.
11.	Song Q, Zhu B, Zhao W, et al. Full-endoscopic lumbar decompression versus open decompression and fusion surgery for the lumbar spinal stenosis: A 3-year follow-up study. J Pain Res, 2021, 14: 1331-1338.
12.	Hua W, Liao Z, Chen C, et al. Clinical outcomes of uniportal and biportal lumbar endoscopic unilateral laminotomy for bilateral decompression in patients with lumbar spinal stenosis: A retrospective pair-matched case-control study. World Neurosurg, 2022, 161: e134-e145.
13.	Young S, Veerapen R, O’Laoire SA. Relief of lumbar canal stenosis using multilevel subarticular fenestrations as an alternative to wide laminectomy: preliminary report. Neurosurgery, 1988, 23(5): 628-633.
14.	Chen T, Zhou G, Chen Z, et al. Biportal endoscopic decompression vs. microscopic decompression for lumbar canal stenosis:A systematic review and meta-analysis. Exp Ther Med, 2020, 20(3): 2743-2751.
15.	Wu J, Guan T, Tian F, et al. Comparision of biportal endoscopic and microscopic decompression in treatment of lumbar spinal stenosis: A comparative study protocol. Medicine (Baltimore), 2020, 99(30): e21309. doi: 10.1097/MD.0000000000021309.
16.	Zhou X, Zhang L, Zhang H L, et al. Clinical outcome and postoperative CT measurements of microendoscopic decompression for lumbar spinal stenosis. Clin Spine Surg, 2017, 30(6): 243-250.
17.	Clark AJ, Safaee MM, Khan NR, et al. Tubular microdiscectomy: techniques, complication avoidance, and review of the literature. Neurosurg Focus, 2017, 43(2): E7. doi: 10.3171/2017.5.FOCUS17202.
18.	Suzuki A, Nakamura H. Microendoscopic lumbar posterior decompression surgery for lumbar spinal stenosis: Literature review. Medicina (Kaunas), 2022, 58(3): 384. doi: 10.3390/medicina58030384.
19.	Nomura K, Yoshida M. Assessment of the learning curve for microendoscopic decompression surgery for lumbar spinal canal stenosis through an analysis of 480 cases involving a single surgeon. Global Spine J, 2017, 7(1): 54-58.
20.	Shriver MF, Xie JJ, Tye EY, et al. Lumbar microdiscectomy complication rates: a systematic review and meta-analysis. Neurosurg Focus, 2015, 39(4): E6. doi: 10.3171/2015.7.FOCUS15281.
21.	Arts MP, Brand R, van den Akker ME, et al. Tubular diskectomy vs conventional microdiskectomy for sciatica: a randomized controlled trial. JAMA, 2009, 302(2): 149-158.
22.	Teli M, Lovi A, Brayda-Bruno M, et al. Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy. Eur Spine J, 2010, 19(3): 443-450.
23.	German JW, Adamo MA, Hoppenot RG, et al. Perioperative results following lumbar discectomy: comparison of minimally invasive discectomy and standard microdiscectomy. Neurosurg Focus, 2008, 25(2): E20. doi: 10.3171/FOC/2008/25/8/E20.
24.	Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: Surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976), 2002, 27(7): 722-731.
25.	Hoogland T, Schubert M, Miklitz B, et al. Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine (Phila Pa 1976), 2006, 31(24): E890-E897.
26.	Lewandrowski KU. Incidence, management, and cost of complications after transforaminal endoscopic decompression surgery for lumbar foraminal and lateral recess stenosis: A value proposition for outpatient ambulatory surgery. Int J Spine Surg, 2019, 13(1): 53-67.
27.	Yeung A, Roberts A, Zhu L, et al. Treatment of soft tissue and bony spinal stenosis by a visualized endoscopic transforaminal technique under local anesthesia. Neurospine, 2019, 16(1): 52-62.
28.	Song QP, Hai B, Zhao WK, et al. Full-endoscopic foraminotomy with a novel large endoscopic trephine for severe degenerative lumbar foraminal stenosis at L₅ S₁ level: An advanced surgical technique. Orthop Surg, 2021, 13(2): 659-668.
29.	Yin G, Huang B, Wang C, et al. Therapeutic effects of full endoscopic spine surgery via transforaminal approach in elderly patients with lumbar spinal stenosis: A retrospective clinical study. Acta Orthop Traumatol Turc, 2021, 55(2): 166-170.
30.	Lv Z, Jin L, Wang K, et al. Comparison of effects of PELD and fenestration in the treatment of geriatric lumbar lateral recess stenosis. Clin Interv Aging, 2019, 14: 2187-2194.
31.	Xie P, Feng F, Chen Z, et al. Percutaneous transforaminal full endoscopic decompression for the treatment of lumbar spinal stenosis. BMC Musculoskelet Disord, 2020, 21(1): 546. doi: 10.1186/s12891-020-03566-x.
32.	Fan G, Wang T, Hu S, et al. Isocentric navigation of percutaneous endoscopic transforaminal discectomy at the L₅/S₁ level in difficult puncture cases: A technical note. Pain Physician, 2017, 20(4): E531-E540.
33.	Yue JJ, Long W. Full endoscopic spinal surgery techniques: Advancements, indications, and outcomes. Int J Spine Surg, 2015, 9: 17. doi: 10.14444/2017.
34.	Pan M, Li Q, Li S, et al. Percutaneous endoscopic lumbar discectomy: Indications and complications. Pain Physician, 2020, 23(1): 49-56.
35.	Ahn Y. Transforaminal percutaneous endoscopic lumbar discectomy: technical tips to prevent complications. Expert Rev Med Devices, 2012, 9(4): 361-366.
36.	Ruetten S, Komp M, Godolias G. A New full-endoscopic technique for the interlaminar operation of lumbar disc herniations using 6-mm endoscopes: prospective 2-year results of 331 patients. Minim Invasive Neurosurg, 2006, 49(2): 80-87.
37.	张斌, 孔清泉, 杨进, 等. 经皮内镜下经椎间孔入路双侧减压治疗重度腰椎中央管狭窄症近期疗效. 中国修复重建外科杂志, 2019, 33(11): 1399-1405.
38.	Lee CH, Choi M, Ryu DS, et al. Efficacy and safety of full-endoscopic decompression via interlaminar approach for central or lateral recess spinal stenosis of the lumbar spine: A meta-analysis. Spine (Phila Pa 1976), 2018, 43(24): 1756-1764.
39.	Nie H, Zeng J, Song Y, et al. Percutaneous endoscopic lumbar discectomy for L₅-S₁ disc herniation via an interlaminar approach versus a transforaminal approach: A prospective randomized controlled study with 2-year follow up. Spine (Phila Pa 1976), 2016, 41 Suppl 19: B30-B37.
40.	Komp M, Hahn P, Oezdemir S, et al. Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study. Pain Physician, 2015, 18(1): 61-70.
41.	Yadav YR, Parihar V, Kher Y, et al. Endoscopic inter laminar management of lumbar disease. Asian J Neurosurg, 2016, 11(1): 1-7.
42.	Dowling Á, Lewandrowski KU, da Silva FHP, et al. Patient selection protocols for endoscopic transforaminal, interlaminar, and translaminar decompression of lumbar spinal stenosis. J Spine Surg, 2020, 6(Suppl 1): S120-S132.
43.	Rita AD, Levi V, Gribaudi GL, et al. The interlaminar contralateral approach to far-lateral lumbar disc herniations: a singlecenter comparison with traditional techniques and literature review. J Neurosurg Sci, 2023, 67(2): 191-199.
44.	Pao JL, Lin SM, Chen WC, et al. Unilateral biportal endoscopic decompression for degenerative lumbar canal stenosis. J Spine Surg, 2020, 6(2): 438-446.
45.	Kim N, Jung SB. Percutaneous unilateral biportal endoscopic spine surgery using a 30-degree arthroscope in patients with severe lumbar spinal stenosis: A technical note. Clin Spine Surg, 2019, 32(8): 324-329.
46.	Heo DH, Son SK, Eum JH, et al. Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results. Neurosurg Focus, 2017, 43(2): E8. doi: 10.3171/2017.5.FOCUS17146.
47.	孔凡国, 周全, 乔杨, 等. 单侧双通道内镜下与微创通道下经椎间孔腰椎间融合术治疗腰椎退行性疾病的疗效比较. 中国修复重建外科杂志, 2022, 36(5): 592-599.
48.	Kang MS, Park HJ, You KH, et al. Comparison of primary versus revision lumbar discectomy using a biportal endoscopic technique. Global Spine J, 2022. doi: 10.1177/21925682211068088.
49.	Heo DH, Lee DC, Park CK. Comparative analysis of three types of minimally invasive decompressive surgery for lumbar central stenosis: biportal endoscopy, uniportal endoscopy, and microsurgery. Neurosurg Focus, 2019, 46(5): E9. doi: 10.3171/2019.2.FOCUS197.
50.	Chen L, Zhu B, Zhong HZ, et al. The learning curve of unilateral biportal endoscopic (UBE) spinal surgery by CUSUM analysis. Front Surg, 2022, 9: 873691. doi: 10.3389/fsurg.2022.873691.
51.	余可谊. 单侧双通道脊柱内镜技术的发展简史、全球现状与中国使命. 中国修复重建外科杂志, 2022, 36(10): 1181-1185.
52.	Choi CM. Biportal endoscopic spine surgery (BESS): considering merits and pitfalls. J Spine Surg, 2020, 6(2): 457-465.
53.	Choi CM, Chung JT, Lee SJ, et al. How I do it? Biportal endoscopic spinal surgery (BESS) for treatment of lumbar spinal stenosis Acta Neurochir (Wien), 2016, 158(3): 459-463.
54.	王彬, 武振方, 何鹏, 等. 单侧双通道脊柱内镜技术并发症及处理的研究进展. 医学研究生学报, 2021, 34(7): 756-760.
55.	Jiang HW, Chen CD, Zhan BS, et al. Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation: a retrospective study. J Orthop Surg Res, 2022, 17(1): 30. doi: 10.1186/s13018-022-02929-5.

1. Kalichman L, Cole R, Kim DH, et al. Spinal stenosis prevalence and association with symptoms: the Framingham Study. Spine J, 2009, 9(7): 545-550.
2. Schneider MJ, Ammendolia C, Murphy DR, et al. Comparative clinical effectiveness of nonsurgical treatment methods in patients with lumbar spinal stenosis: A randomized clinical trial. JAMA Netw Open, 2019, 2(1): e186828. doi: 10.1001/jamanetworkopen.2018.6828.
3. 谢瑞, 于杰, 梁龙, 等. 腰椎管狭窄患者的手术和非手术治疗: 丹麦国家临床指南解读. 天津中医药, 2020, 37(1): 33-37.
4. Mobbs RJ, Li J, Sivabalan P, et al. Outcomes after decompressive laminectomy for lumbar spinal stenosis: comparison between minimally invasive unilateral laminectomy for bilateral decompression and open laminectomy: clinical article. J Spine Surg, 2014, 21(2): 179-186.
5. Fan N, Yuan S, Du P, et al. Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis. BMC Musculoskelet Disord, 2021, 22(1): 1041. doi: 10.1186/s12891-021-04940-z.
6. Mobbs RJ, Phan K, Malham G, et al. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg, 2015, 1(1): 2-18.
7. Försth P, Ólafsson G, Carlsson T, et al. A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med, 2016, 374(15): 1413-1423.
8. Li H, Ou Y, Xie F, et al. Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study. J Orthop Surg Res, 2020, 15(1): 441. doi: 10.1186/s13018-020-01968-0.
9. Hwa Eum J, Hwa Heo D, Son SK, et al. Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. J Neurosurg Spine, 2016, 24(4): 602-607.
10. 黎庆初, 谭斌, 刘雄文, 等. 显微内窥镜下应用改良器械减压治疗腰椎管狭窄症. 中国脊柱脊髓杂志, 2008, (5): 341-344.
11. Song Q, Zhu B, Zhao W, et al. Full-endoscopic lumbar decompression versus open decompression and fusion surgery for the lumbar spinal stenosis: A 3-year follow-up study. J Pain Res, 2021, 14: 1331-1338.
12. Hua W, Liao Z, Chen C, et al. Clinical outcomes of uniportal and biportal lumbar endoscopic unilateral laminotomy for bilateral decompression in patients with lumbar spinal stenosis: A retrospective pair-matched case-control study. World Neurosurg, 2022, 161: e134-e145.
13. Young S, Veerapen R, O’Laoire SA. Relief of lumbar canal stenosis using multilevel subarticular fenestrations as an alternative to wide laminectomy: preliminary report. Neurosurgery, 1988, 23(5): 628-633.
14. Chen T, Zhou G, Chen Z, et al. Biportal endoscopic decompression vs. microscopic decompression for lumbar canal stenosis:A systematic review and meta-analysis. Exp Ther Med, 2020, 20(3): 2743-2751.
15. Wu J, Guan T, Tian F, et al. Comparision of biportal endoscopic and microscopic decompression in treatment of lumbar spinal stenosis: A comparative study protocol. Medicine (Baltimore), 2020, 99(30): e21309. doi: 10.1097/MD.0000000000021309.
16. Zhou X, Zhang L, Zhang H L, et al. Clinical outcome and postoperative CT measurements of microendoscopic decompression for lumbar spinal stenosis. Clin Spine Surg, 2017, 30(6): 243-250.
17. Clark AJ, Safaee MM, Khan NR, et al. Tubular microdiscectomy: techniques, complication avoidance, and review of the literature. Neurosurg Focus, 2017, 43(2): E7. doi: 10.3171/2017.5.FOCUS17202.
18. Suzuki A, Nakamura H. Microendoscopic lumbar posterior decompression surgery for lumbar spinal stenosis: Literature review. Medicina (Kaunas), 2022, 58(3): 384. doi: 10.3390/medicina58030384.
19. Nomura K, Yoshida M. Assessment of the learning curve for microendoscopic decompression surgery for lumbar spinal canal stenosis through an analysis of 480 cases involving a single surgeon. Global Spine J, 2017, 7(1): 54-58.
20. Shriver MF, Xie JJ, Tye EY, et al. Lumbar microdiscectomy complication rates: a systematic review and meta-analysis. Neurosurg Focus, 2015, 39(4): E6. doi: 10.3171/2015.7.FOCUS15281.
21. Arts MP, Brand R, van den Akker ME, et al. Tubular diskectomy vs conventional microdiskectomy for sciatica: a randomized controlled trial. JAMA, 2009, 302(2): 149-158.
22. Teli M, Lovi A, Brayda-Bruno M, et al. Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy. Eur Spine J, 2010, 19(3): 443-450.
23. German JW, Adamo MA, Hoppenot RG, et al. Perioperative results following lumbar discectomy: comparison of minimally invasive discectomy and standard microdiscectomy. Neurosurg Focus, 2008, 25(2): E20. doi: 10.3171/FOC/2008/25/8/E20.
24. Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: Surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976), 2002, 27(7): 722-731.
25. Hoogland T, Schubert M, Miklitz B, et al. Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine (Phila Pa 1976), 2006, 31(24): E890-E897.
26. Lewandrowski KU. Incidence, management, and cost of complications after transforaminal endoscopic decompression surgery for lumbar foraminal and lateral recess stenosis: A value proposition for outpatient ambulatory surgery. Int J Spine Surg, 2019, 13(1): 53-67.
27. Yeung A, Roberts A, Zhu L, et al. Treatment of soft tissue and bony spinal stenosis by a visualized endoscopic transforaminal technique under local anesthesia. Neurospine, 2019, 16(1): 52-62.
28. Song QP, Hai B, Zhao WK, et al. Full-endoscopic foraminotomy with a novel large endoscopic trephine for severe degenerative lumbar foraminal stenosis at L₅ S₁ level: An advanced surgical technique. Orthop Surg, 2021, 13(2): 659-668.
29. Yin G, Huang B, Wang C, et al. Therapeutic effects of full endoscopic spine surgery via transforaminal approach in elderly patients with lumbar spinal stenosis: A retrospective clinical study. Acta Orthop Traumatol Turc, 2021, 55(2): 166-170.
30. Lv Z, Jin L, Wang K, et al. Comparison of effects of PELD and fenestration in the treatment of geriatric lumbar lateral recess stenosis. Clin Interv Aging, 2019, 14: 2187-2194.
31. Xie P, Feng F, Chen Z, et al. Percutaneous transforaminal full endoscopic decompression for the treatment of lumbar spinal stenosis. BMC Musculoskelet Disord, 2020, 21(1): 546. doi: 10.1186/s12891-020-03566-x.
32. Fan G, Wang T, Hu S, et al. Isocentric navigation of percutaneous endoscopic transforaminal discectomy at the L₅/S₁ level in difficult puncture cases: A technical note. Pain Physician, 2017, 20(4): E531-E540.
33. Yue JJ, Long W. Full endoscopic spinal surgery techniques: Advancements, indications, and outcomes. Int J Spine Surg, 2015, 9: 17. doi: 10.14444/2017.
34. Pan M, Li Q, Li S, et al. Percutaneous endoscopic lumbar discectomy: Indications and complications. Pain Physician, 2020, 23(1): 49-56.
35. Ahn Y. Transforaminal percutaneous endoscopic lumbar discectomy: technical tips to prevent complications. Expert Rev Med Devices, 2012, 9(4): 361-366.
36. Ruetten S, Komp M, Godolias G. A New full-endoscopic technique for the interlaminar operation of lumbar disc herniations using 6-mm endoscopes: prospective 2-year results of 331 patients. Minim Invasive Neurosurg, 2006, 49(2): 80-87.
37. 张斌, 孔清泉, 杨进, 等. 经皮内镜下经椎间孔入路双侧减压治疗重度腰椎中央管狭窄症近期疗效. 中国修复重建外科杂志, 2019, 33(11): 1399-1405.
38. Lee CH, Choi M, Ryu DS, et al. Efficacy and safety of full-endoscopic decompression via interlaminar approach for central or lateral recess spinal stenosis of the lumbar spine: A meta-analysis. Spine (Phila Pa 1976), 2018, 43(24): 1756-1764.
39. Nie H, Zeng J, Song Y, et al. Percutaneous endoscopic lumbar discectomy for L₅-S₁ disc herniation via an interlaminar approach versus a transforaminal approach: A prospective randomized controlled study with 2-year follow up. Spine (Phila Pa 1976), 2016, 41 Suppl 19: B30-B37.
40. Komp M, Hahn P, Oezdemir S, et al. Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study. Pain Physician, 2015, 18(1): 61-70.
41. Yadav YR, Parihar V, Kher Y, et al. Endoscopic inter laminar management of lumbar disease. Asian J Neurosurg, 2016, 11(1): 1-7.
42. Dowling Á, Lewandrowski KU, da Silva FHP, et al. Patient selection protocols for endoscopic transforaminal, interlaminar, and translaminar decompression of lumbar spinal stenosis. J Spine Surg, 2020, 6(Suppl 1): S120-S132.
43. Rita AD, Levi V, Gribaudi GL, et al. The interlaminar contralateral approach to far-lateral lumbar disc herniations: a singlecenter comparison with traditional techniques and literature review. J Neurosurg Sci, 2023, 67(2): 191-199.
44. Pao JL, Lin SM, Chen WC, et al. Unilateral biportal endoscopic decompression for degenerative lumbar canal stenosis. J Spine Surg, 2020, 6(2): 438-446.
45. Kim N, Jung SB. Percutaneous unilateral biportal endoscopic spine surgery using a 30-degree arthroscope in patients with severe lumbar spinal stenosis: A technical note. Clin Spine Surg, 2019, 32(8): 324-329.
46. Heo DH, Son SK, Eum JH, et al. Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results. Neurosurg Focus, 2017, 43(2): E8. doi: 10.3171/2017.5.FOCUS17146.
47. 孔凡国, 周全, 乔杨, 等. 单侧双通道内镜下与微创通道下经椎间孔腰椎间融合术治疗腰椎退行性疾病的疗效比较. 中国修复重建外科杂志, 2022, 36(5): 592-599.
48. Kang MS, Park HJ, You KH, et al. Comparison of primary versus revision lumbar discectomy using a biportal endoscopic technique. Global Spine J, 2022. doi: 10.1177/21925682211068088.
49. Heo DH, Lee DC, Park CK. Comparative analysis of three types of minimally invasive decompressive surgery for lumbar central stenosis: biportal endoscopy, uniportal endoscopy, and microsurgery. Neurosurg Focus, 2019, 46(5): E9. doi: 10.3171/2019.2.FOCUS197.
50. Chen L, Zhu B, Zhong HZ, et al. The learning curve of unilateral biportal endoscopic (UBE) spinal surgery by CUSUM analysis. Front Surg, 2022, 9: 873691. doi: 10.3389/fsurg.2022.873691.
51. 余可谊. 单侧双通道脊柱内镜技术的发展简史、全球现状与中国使命. 中国修复重建外科杂志, 2022, 36(10): 1181-1185.
52. Choi CM. Biportal endoscopic spine surgery (BESS): considering merits and pitfalls. J Spine Surg, 2020, 6(2): 457-465.
53. Choi CM, Chung JT, Lee SJ, et al. How I do it? Biportal endoscopic spinal surgery (BESS) for treatment of lumbar spinal stenosis Acta Neurochir (Wien), 2016, 158(3): 459-463.
54. 王彬, 武振方, 何鹏, 等. 单侧双通道脊柱内镜技术并发症及处理的研究进展. 医学研究生学报, 2021, 34(7): 756-760.
55. Jiang HW, Chen CD, Zhan BS, et al. Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation: a retrospective study. J Orthop Surg Res, 2022, 17(1): 30. doi: 10.1186/s13018-022-02929-5.

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