Efficacy of Unilateral Biportal Endoscopy in the Treatment of Cauda Equina Syndrome: A Retrospective Study

Background: While biportal endoscopy is indicated for various conditions, evidence regarding its efficacy in the management of cauda equina syndrome (CES) remains limited in the current literature. The objective of this study is to evaluate the efficacy of unilateral biportal endoscopy in the treatment of CES. Materials and Methods: A retrospective review included all patients who underwent unilateral biportal endoscopic decompression for acute CES caused by single-level lumbar disc herniation at L3–L4, L4–L5, or L5–S1. Twenty-four patients met the criteria. Demographics (age, sex, body mass index, and time to surgery) and clinical features (back/leg pain, bladder symptoms, saddle anesthesia, and neurological status) were recorded. Results: The mean preoperative Oswestry Disability Index (ODI) was 77.5 ± 6.7. The mean preoperative visual analog scale (VAS) score for leg pain was 8.21 ± 0.79, and the mean preoperative VAS score for back pain was 7.7 ± 1.2. The mean ODI score on postoperative day 1 was 46.5 ± 23.08. The mean VAS for leg pain on postoperative day 1 was 0.95 ± 0.46, whereas the mean VAS for back pain was 2.85 ± 0.74. The mean ODI score at final follow-up (9 months) was 2.4 ± 3.68. The mean VAS for leg pain at final follow-up (9 months) was 0.62 ± 0.57, whereas the mean VAS for back pain at final follow-up was 0.33 ± 0.48. Conclusion: Biportal endoscopy is safe and effective in the management of CES patients.