Complications in Uniportal vs Unilateral Biportal Endoscopic Decompression for Lumbar Spinal Stenosis: A Scoping Review

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Abstract
Study Design: Scoping review. Objective: To review the literature on complications related to uniportal and unilateral biportal endoscopic techniques for lumbar spinal stenosis, identify areas needing further clarification, and enhance the understanding of these techniques. Methodology: A scoping review was conducted in September 2024 across five databases (Google Scholar, Medline, Embase, PubMed, and Web of Science) on complications related to uniportal and unilateral biportal interlaminar endoscopic decompression for lumbar spinal stenosis. Descriptive characteristics, trends, and regional distribution of studies were summarized. Study types, findings, and complications for each technique were tabulated. A comparison of complication rates was performed between the two techniques to assess their relative safety and outcomes. Results: A total of 38 studies involving 2426 patients (17 Uniportal, 17 Biportal, 4 comparing both) were analyzed, with L4-L5 being the most common level operated. The overall complication rate was 2.7% for uniportal and 2.2% for biportal, with reporting inconsistencies noted. Persistent symptoms after surgical decompression were more common in the uniportal group ( P = 0.003), while postoperative headaches were higher in the biportal group ( P = 0.007). However, the number of studies reporting these complications was limited. Conclusion: Both uniportal and unilateral biportal endoscopic techniques are effective for lumbar spinal canal decompression, with no significant difference in complication rates. However, inconsistent reporting across studies limits meaningful meta-analyses. Future research should standardize the reporting of complications to ensure more reliable results and improve research quality.

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