Curative effect of unilateral double channel spinal endoscopy and endoscopic decompression in the treatment of lumbar spinal stenosis:a meta-analysis

Background: The efficacy of unilateral dual-channel spinal endoscopy (UBE) and microscopic endoscopic decompression (MED) in the treatment of lumbar spinal stenosis (LSS) was compared by Meta-analysis. Method PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database were searched by computer for all studies on the treatment of LSS with UBE and MED from the establishment of the database to January 2021. Authors, year of publication, study design, subject characteristics, sample size, surgical protocol, age, sex ratio, duration of surgery, length of hospital stay, complications, visual analogue scale (VAS), and Oswestry Disability Index (ODI) were obtained. The operation time, hospital stay, complication rate, waist and lower extremity VAS score and ODI before operation, early postoperative period and last follow-up were analyzed by Revman 5.3 software. Result Finally, 7 articles were included, including 6 articles in English and 1 article in Chinese; 2 articles were randomized controlled studies, and 5 articles were case-control studies. There were 251 patients in the UBE group and 224 patients in the microscopy group. Compared with the MED group, the UBE group had a shorter hospital stay (MD=-2.28, 95% CI: -3.42~-1.14, P  < 0.001), and a lower VAS score for early postoperative low back pain (MD=-0.80, 95%CI) : -1.44~-0.16, P = 0.01), the difference was statistically significant. There were no significant differences in operation time, complication rate, waist VAS score before operation and at last follow-up, lower extremity VAS score, ODI, and dural expansion area before operation, early after operation and at last follow-up between the two groups ( P  > 0.05). Conclusion Compared with MED, UBE has better early low back pain relief and hospital stay after LSS, but there is no significant difference in long-term efficacy and safety.