A Multicenter Prospective Study of Patient Outcomes After Three Full-Endoscopic Lumbar Decompression Techniques
In brief
Three lumbar decompression techniques showed favorable outcomes; pain differences were small
In a prospective study of 623 patients at 10 centers, all three endoscopic techniques were associated with favorable safety and midterm outcomes. After adjustment, patients treated with TELD reported lower back-pain scores than those treated with UBE from 3 to 12 months, but the differences were smaller than the threshold for a meaningful change. Because the study was observational, it cannot establish which technique is best.
- Journal
- Spine (Q1)
- Published
- 2 November 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Guihe Yang, Zheng Zhang, Yuqi Ge, Jiayuan Wu, Hao Li, Fangfang Duan, et al.
- PMID
- 42970444
- DOI
- 10.1097/BRS.0000000000005911
Why clinicians should know about it
- Picked for Spine Surgery (paper of the day, 5 November 2026): Prospective multicenter comparison of endoscopic lumbar decompression techniques
Abstract
STUDY DESIGN: Multicenter prospective observational study. OBJECTIVE: To characterize the application and outcome profiles of TELD, IELD, and UBE in routine clinical practice. SUMMARY OF BACKGROUND DATA: Full-endoscopic lumbar surgery has been widely used in the treatment of lumbar disc herniation, yet multicenter prospective evidence on patient outcomes in real-world clinical practice remains limited. METHODS: This multicenter prospective real-world study was conducted across 10 medical centers in four regions of China. Perioperative parameters, complications, and patient-reported outcome measures at postoperative day 1 and at 3, 6, and 12 months were recorded. Descriptive group comparisons were supplemented by adjusted repeated-measures analyses accounting for baseline outcome values, clinical covariates, operative level, and center. RESULTS: A total of 623 patients were included: 105 in the TELD group, 109 in the IELD group, and 409 in the UBE group. Preoperative pain intensity, operative-level distribution, sensory deficit, and center distribution differed among groups. In adjusted analyses, TELD was associated with lower back-pain VAS than UBE at 3 months (mean difference, -0.73; 95% CI, -1.06 to -0.40; Holm P<0.001), 6 months (-0.51; -0.82 to -0.21; P=0.005), and 12 months (-0.77; -0.96 to -0.57; P<0.001). These differences were below the 3-point VAS MCID. CONCLUSIONS: TELD, IELD, and UBE were associated with favorable safety and midterm outcomes in this multicenter cohort. TELD was associated with modestly lower postoperative back-pain scores than UBE after adjustment for measured differences; however, the absolute differences did not reach the prespecified MCID and do not establish causal or universal procedural superiority. LEVEL OF EVIDENCE: Level 3.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.