What question did this study set out to answer?

To compare clinical and radiographic outcomes of unpowered osteotome-assisted and powered drill-assisted UBE techniques in treating lumbar spinal stenosis.

April 28, 2026European journal of medical research0 citationsOpen Access

Clinical outcomes of unpowered osteotome-assisted unilateral biportal endoscopy (UBE) for the treatment of lumbar spinal stenosis: a retrospective cohort study

WHWeiran HuZhengzhou University HWHongqiang WangZhengzhou University HWHaoxu WangZhengzhou University

Key Points

To compare clinical and radiographic outcomes of unpowered osteotome-assisted and powered drill-assisted UBE techniques in treating lumbar spinal stenosis.
Retrospective review of 127 consecutive patients undergoing UBE (unpowered or powered) for lumbar spinal stenosis.
Assessment of perioperative variables, blood loss, complications, and clinical outcomes using JOA and VAS scores.
Postoperative CT and MRI evaluated decompression adequacy and facet preservation between the techniques.
Both groups showed comparable JOA scores (21.07 ± 2.76 vs 21.74 ± 2.06, p = 0.151) and VAS scores for leg pain (2.31 ± 0.46 vs 2.47 ± 0.47, p = 0.451).
Total blood loss did not significantly differ (257.42 ± 101.76 vs 247.78 ± 117.89 mL, p = 0.165).
Operative time was shorter in the unpowered osteotome group (101.64 ± 34.76 min vs 124.76 ± 46.73 min, p = 0.041).

Abstract

Retrospective cohort study. To compare the clinical and radiographic outcomes of unpowered osteotome-assisted versus powered drill-assisted unilateral biportal endoscopy (UBE) for the treatment of single-level lumbar spinal stenosis. We retrospectively reviewed 127 consecutive patients who underwent UBE using either an unpowered osteotome or a powered drill. Perioperative variables, blood loss-related parameters, complications, and serial clinical outcomes were collected. Postoperative CT and MRI were used to compare the adequacy of decompression and facet preservation between the two techniques. Clinical outcomes were comparable between the two groups. At the final follow-up, the JOA score was 21.07 ± 2.76 in the unpowered osteotome group and 21.74 ± 2.06 in the powered drill group (p = 0.151), whereas the corresponding VAS score for leg pain was 2.31 ± 0.46 versus 2.47 ± 0.47 (p = 0.451). Total blood loss did not differ significantly between groups (257.42 ± 101.76 vs 247.78 ± 117.89 mL, p = 0.165). Operative time was significantly shorter in the unpowered osteotome group (101.64 ± 34.76 vs 124.76 ± 46.73 min, p = 0.041). At 12 months, radiographic parameters, including the lateral recess angle, lateral recess height, superior articular distance, spinal canal area, and facet joint preservation rate, were comparable between groups. In this retrospective cohort, unpowered osteotome-assisted UBE achieved clinical and radiographic outcomes comparable to those of powered drill-assisted UBE, without increasing blood loss or complications, while shortening operative time.

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