Minimally Invasive Techniques for Lumbar Burst Fractures: A Systematic Review of Unilateral Biportal Endoscopic Vertebroplasty and Decompression

Introduction: Lumbar burst fractures are complex injuries requiring stabilization and decompression, particularly when neurological deficits are present. Minimally invasive approaches, including unilateral biportal endoscopic vertebroplasty and decompression (UBEVD), offer potential benefits, such as reduced tissue damage and quicker recovery. This systematic review evaluates the efficacy and safety of UBEVD in treating lumbar burst fractures.

Methods: A systematic review was conducted following PRISMA guidelines. Studies published from 2010 to 2023 were identified using PubMed, Embase, and Cochrane Library databases. Data extraction focused on outcomes like kyphotic angle correction, pain relief (VAS score), surgical time, and complication rates. Analysis was performed using Python and R, with meta-analytic models applied to estimate pooled effects and heterogeneity assessed with the I² statistic.

Results: A total of 15 studies involving 674 patients were included. The pooled data showed a significant reduction in kyphotic angle (mean correction of 11.3°, 95% CI: 9.2–13.4, p < 0.001) and a VAS pain score improvement by an average of 5.2 points (95% CI: 4.8–5.6). Average surgical time for UBEVD was 102 minutes (95% CI: 85–119), and the complication rate was low at 6%, mainly minor dural tears and transient radiculopathy. Heterogeneity was moderate (I² = 48%), likely due to variability in fracture severity and patient demographics.

Conclusion : UBEVD demonstrates promising results in managing lumbar burst fractures, achieving substantial kyphotic correction, pain relief, and reduced complication rates compared to conventional techniques. With shorter surgical times and favorable outcomes, UBEVD could be considered an effective option for select patients with lumbar burst fractures. Further controlled trials are necessary to strengthen evidence on its long-term effectiveness.