Percutaneous Endoscopic Lumbar Decompression for Lumbar Lateral Recess Stenosis: A Systematic Review.
Shanxi Wang, Jianbin Guan, Kaitan Yang et al.
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In 30 seconds
This systematic review compared percutaneous interlaminar endoscopic discectomy (PIED), percutaneous transforaminal endoscopic discectomy (PTED), and unilateral biportal endoscopy (UBE) for lumbar lateral recess stenosis. It included 36 studies involving 2341 patients, with 6-60 months of follow-up; heterogeneity led to narrative synthesis. All three approaches were associated with pain and functional improvement. PTED showed consistent pain relief and ODI reductions >50%, with satisfaction of 85-95%, short operative times, and complication and reoperation rates <5%. Overall study quality ranged from low to moderate risk of bias.
Key findings
- PIED was associated with VAS reductions of 3-5 points and ODI reductions of 40-60%; dural tears occurred in 3-6% and reoperation rates were 5-9.7%.
- UBE was associated with VAS improvements of 5-7 points, ODI reductions of 50-70%, and satisfaction >92%; operative times were 48-91 min.
- PTED showed pain scores improving from VAS 6-8 to 1-2, ODI reductions >50%, satisfaction of 85-95%, and complication and reoperation rates <5%.
Why it matters
The review suggests that several endoscopic approaches can improve pain and function in lumbar lateral recess stenosis, while their procedural profiles differ. These comparisons may help frame discussions of technique selection, including trade-offs in operative time, complications, and reported outcomes. However, the evidence base has low to moderate risk of bias, so apparent differences between approaches should be interpreted cautiously.
What to keep in mind
The included studies were heterogeneous, requiring narrative synthesis, and overall study quality ranged from low to moderate risk of bias.