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Review Article | DOI: https://doi.org/10.31579/2578-8868/390
1 Head of Neurosurgical Department, Juaneda Hospital Miramar, Palma de Mallorca, Balearic Islands, Spain
*Corresponding Author: Gonçalo Januário, Head of Neurosurgical Department, Juaneda Hospital Miramar, Palma de Mallorca, Balearic Islands, Spain
Citation: Gonçalo Januário, (2025), Comparison Between Uniportal and Biportal Endoscopic Techniques in Spine Surgeries, J. Neuroscience and Neurological Surgery, 18(1); DOI:10.31579/2578-8868/390
Copyright: ©, 2025, Gonçalo Januário. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Received: 01 October 2025 | Accepted: 20 October 2025 | Published: 05 November 2025
Keywords: spine surgery, minimal invasive, endoscopy, uniportal, biportal, degenerative diseases.
Endoscopic spine surgery are minimally invasive alternatives to conventional open surgery for degenerative spinal diseases, actually two techniques are available. Uniportal full endoscopy (UFE) and Unilateral Biportal Endoscopy (UBE), the two techniques are used in spinal surgeries. Both methods aim to reduce tissue damage, shorten recovery times, and improve patient outcomes.
UFE involves a single portal through which both the visualization and instruments are introduced, typically offering reduced scarring.
On the other hand, UBE utilizes two portals on the same side of the body, one for visualization with endoscope, and the other for instruments insertion.
Studies comparing the two techniques highlight differences in surgical approaches and outcomes. UFE is generally considered more challenging due to the complexity of operating with a single portal, requiring advanced skill and precision. However, it offers superior cosmetic results with a smaller incision, potentially leading to less postoperative pain and quicker recovery, no differences in many studies.
UBE, while involving two incisions, less than 1 cm, due to the use of two portals, allows for better instrument maneuverability control and visualization, making it advantageous for more complex procedures. UBE also provides greater flexibility, more than UFE, during the surgical manipulation.
In terms of clinical outcomes, both techniques show comparable results about complications, recovery times, and postoperative pain.
The choice between UFE and UBE often depends on the surgeon’s experience, the complexity of the procedure, and patient-specific factors.
Overall, both methods represent significant advancements in minimally invasive surgery, providing safer alternatives to traditional open procedures with distinct advantages and limitations.
The Uniportal Full Endoscopy (UFE) and Unilateral Biportal Endoscopy (UBE) are advanced minimally invasive techniques that allow surgeons to perform procedures through small incisions, channels, one or two respectively.
In this manuscript we explain the use of both techniques, attempting to make an objective evaluation their respective advantages, disadvantages and limitations.
These techniques have their advantages and limitations, but with time and constant development the limitations are less.1
Globally, we can dived the endoscopic spine surgery in two main groups, one working channel and two working channels. In cases of multilevel pathologies to treated in the same surgery both techniques use multi channels. The materials in those thecniques are different, but the goal it’s the same, decompress the nerve root with a minimal invasive approach. Also, both techniques could be associated with fusion process if necessary.
Both techniques present different approaches, in case of UFE offer two primary techniques: interlaminar and transforaminal, each with its own advantages for different pathologies.
In case of UBE, this thecnique use two approaches, the most common is interlaminar with uni or bilateral access. The other option is extraforaminal approach for nerve root compressions outside the medular canal, as in cases of foraminal or extraforaminal disc herniation.
Before the tricks and trucks of both endoscopic techniques it’s important clarify, especially for all those professionals who are starting to contact with the spinal endoscopy, that since the emergence of the two major endoscopic techniques for spinal treatment, their names have changed. Many studies that refer to them by different names.
The uniportal technique over the years it has been called “full endoscopy”, “microendoscopy” involves a single working channel, but the size is large enough to allow for multiple instruments to be used concurrently, and independent of the endoscope “one-hole split endoscopy” (OSE)
The biportal technique at the beginning named Biportal Endoscopic Spine Surgery (BESS), posteriorly Unilateral Biportal Endoscopy (UBE) or two-portal endoscopic spinal surgery.
A. Uniportal Endoscopy for Spine Surgeries:
Uniportal full spine endoscopy is an emerging technique in spinal surgery that leverages a minimally invasive approach to access the entire spine through a single incision, combining endoscopic technology with traditional surgical principles. It is a technique that is currently used in the 3 levels of the spine (cervical, thoracic, lumbar).
Is considered an advancement over previous spinal procedures due to its potential for less tissue disruption, faster recovery and reduced complications.
History and Development of Uniportal Full Spine Endoscopy:
1. Origins in Minimally Invasive Spine Surgery:
The development of minimally invasive spine surgery (MISS) dates back to the late 20th century, with a focus on reducing the invasiveness of traditional spinal procedures. Early approaches aimed to minimize muscle and tissue disruption while still providing effective treatment for spinal conditions.
The 1990s saw the introduction of endoscopic spinal surgery, particularly for lumbar discectomy. These techniques utilized small incisions and endoscopes to visualize the spine, facilitating procedures without the need for large incisions.
2. Advancements in Endoscopic Spine Surgery:
Over the next two decades, there were significant advancements in endoscopic equipment and techniques, particularly focusing on lumbar and cervical spine surgeries.
By the early 2000s, endoscopic spine surgeries began to be used for a variety of conditions, including spinal stenosis, herniated discs, and decompression procedures. Surgeons also started using percutaneous techniques for facet joint injections, biopsies, and other minimally invasive interventions.
3. The Emergence of Uniportal (Single-Incision) Spine Surgery:
In the mid-2010s, there was a shift toward uniportal or single-incision spine surgery, inspired by the principles of minimal access surgery. Surgeons aimed to reduce the number of incisions, focusing on improving patient outcomes through a single access point.
Early studies demonstrated that uniportal procedures allowed for faster recovery, reduced muscle disruption, and a decrease in post-operative pain.
4. General concepts in Uniportal Full Spine Endoscopy:
The concept of uniportal full spine endoscopy emerged as a way to address spinal conditions in the entire spine (cervical, thoracic, lumbar) through a single incision, using advanced endoscopic systems.
Surgeons began employing full spine endoscopy for spinal conditions such as disc herniation, spinal deformities, and stenosis. The use of high-definition cameras and specialized instruments made it possible to perform decompressions, discectomies, and even spinal fusions with minimal access.
5. Current Trends and Research:
Research on uniportal full spine endoscopy is ongoing, with a focus on understanding the benefits and challenges associated with this technique. Studies emphasize that the technique can lead to faster recovery times, reduced blood loss, and lower complication rates compared to traditional open spinal surgeries.
Some key studies in the literature that explore uniportal full spine endoscopy and minimally invasive techniques include those published in journals such as Spine, The Journal of Neurosurgery: Spine, and The European Spine Journal.
For instance, discussing innovations in endoscopic techniques for minimally invasive spine surgery and providing insights into their potential for future applications in complex spinal conditions.
Indications:
Uniportal endoscopy is increasingly being utilized for a range of spinal procedures, particularly for patients who would benefit from less invasive approaches. Common indications for UFE in spine surgery include:
Recommendations:
For successful implementation of uniportal endoscopy in spine surgery, several key recommendations should be followed:
Advantages:
UFE offers several distinct advantages in spine surgery:
Disadvantages:
• Limited instrument mobility: using only one portal for both visualization and operation can limit the mobility of instruments.
• Challenges in ergonomics: surgeons might struggle with optimal angles and views, especially in complex surgeries.
• Skill requirement: a high level of expertise and experience is required for the surgeon to achieve optimal outcomes.
• Visualization depth: limited depth of view compared to multi-portal techniques, which could affect visibility of deeper structures.
• Limited for complex cases: in more intricate procedures, UE might not provide the necessary maneuverability for complex dissection.
Limitations:
• Technical demands: requires specialized equipment and proficiency.
• Learning curve: Surgeons need specific training to effectively use uniportal techniques, as improper technique may compromise surgical outcomes.
B. Unilateral Biportal Endoscopy for Spine Surgeries:
Unilateral Biportal Endoscopy (UBE) has emerged as another minimally invasive technique for various types of spinal disease.2
By adhering to these recommendations, surgeons can leverage UBE to achieve favorable clinical outcomes, including significant improvements in pain relief and functional recovery.
UBE is a useful technique where two small incisions are made, both, on the same side (unilateral) of the body. Permit unilateral or bilateral decompression for the treatment of spinal canal stenosis, foraminal stenosis, ossification of the ligament flavum, low-grade spondylolisthesis, and adjacent segment degeneration.
This floating surgical technique has several advantages over conventional spine surgery, including less tissue damage, less blood loss, shorter hospital stays, and faster recovery.
In addition, the early clinical outcomes are favorable, and present a low rate of complications, such as dura tearing, nerve traction injury, and postoperative hematoma.
It has been successfully used in spinal surgery, particularly for lumbar discectomy and other decompressive surgeries. Currently, this technique is expanding and is used at all three levels (cervical, thoracic, lumbar) of the spine and in different pathologies, especially in degenerative spinal pathologies.
In UBE is essential the patient positioning, portals creation, endoscopic visualization, decompression, and fusion when recommended associated with the decompression.
Recommendations:
1. Patient positioning and surgical approach
Proper patient positioning is crucial for optimal surgical access and visualization. The interlaminar approach is commonly used for lumbar disc herniation, central or lateral recess stenoses, in cases of bilateral stenosis this technique permit a contralateral approach.3
The paraspinal/extraforaminal approach is effective for foraminal or specially extraforaminal disc herniations or foraminal stenosis, particularly at the L5–S1 level.4
2. Minimizing bone resection
UBE allows for less bone resection compared to traditional methods, reducing the risk of complications such as pars fractures. This approach enhances visualization and preserves spinal stability. In patients with lumbar disc herniation, treated with UBE interlaminar approach its mandatory don’t resect bone except if it’s really necessary. As in microdiscectomy respect the facet joint it’s recommended for prevent instability after the surgery and during the follow-up period.
3. Enhanced visualization and precision
The dual-portal system of UBE provides superior illumination and magnification, facilitating precise decompression and minimizing soft tissue damage. Continuous irrigation helps maintain a clear surgical field and reduces the risk of infection. The high range of movements it’s a important advantage of this technique when compared with uniportal or with microscopic surgeries.
4. Training and certification
Surgeons should undergo comprehensive training to master UBE techniques. A tutor that help to progress in the technique, anatomic study, and select the most “easy cases” at the beginning (example, lumbar disc herniation L4-L5 or L5-S1 in a fit patient). For simulate the real surgeries the participations in cadaveric courses or more recently technical box with hyper-realistic simulation systems and mixed reality can accelerating skill development.
The European Society of Unilateral Biportal Endoscopy (ESUBE) offers a certification program, requiring a minimum of 100 successful UBE cases, including lumbar disc herniations and spinal stenosis.
Advantages:
Disadvantages:
Limitations:
Personally, I believe that UBE are a great and positive development in minimal invasive spine surgeries and particularly in endoscopic surgery. I consider it to be a a natural evolution of UFE, and although it may seem like a more invasive technique than uniportal surgery, to date, there's no study demonstrating a statistically significant difference at this level. We must take into account all the advantages and evolution that this technique presents.
Recent relevant publications of each of the techniques and comparison between them or older techniques:
• UFE relevants manuscripts:
The first reference that we use related with this technique is a Meta-analysis with 6 RCTs involving a total of 646 patients. The study compared microscopic and full-endoscopic spinal decompression. The authors of this meta-analysis concluded, with statistically significant results of P value that Full-
endoscopic spinal decompression is a better treatment for lumbar spinal stenosis with more effective leg pain improvement, shorter operative time, and fewer complications than microscopic decompression. This study is supported by a statistical power of 98.57%, 99.97%, and 81.88%, respectively.7
Another study described that Uniportal endoscopic technique are growing in popularity and they are safe and effective. And also allow for rapid functional recovery with reduced morbidity compared to open and other MIS techniques.While there is increasing interest in endoscopic lumbar decompression, widespread adoption has been slowed in part due to the steep learning curve and lack of exposure in many formalized training programs. Finally, they concluded that endoscopic interlaminar and transforaminal techniques are safe and effective with at least non-inferior long-term outcomes and faster recovery compared to traditional open and MIS counterparts.8
Another comprehensive literature search across multiple databases identified a total of 418 records. After a screening process for eligibility, finally the meta-analyses incorporated 10 of the 14 RCTs and 25 of the 30 cohort studies. The inclusion criterion, used, ensured a comprehensive aggregation of data, providing a robust foundation for the analysis. Further exploration was dedicated to identifying case reports detailing complications, resulting in the discovery of three pertinent articles. In addition to the case reports, our search also unveiled two review articles addressing complications, which included descriptions of atypical complications. This further enriched the understanding of the diverse range of adverse outcomes associated with this technique.9
The results of the meta-analyses for complication-related insights, all studies conducted a systematic examination of complications. 8 of these studies calculated the incidence rates of complications, with only 1 making a distinction between the transforaminal and interlaminar approaches. 5 meta-analyses categorized complications by type, enabling us to identify the most reported complications across the studies.9
The comparative analysis of complication rates among different lumbar discectomy techniques—specifically transforaminal endoscopic lumbar discectomy (TELD), interlaminar endoscopic lumbar discectomy (IELD), and microscopic lumbar discectomy (MLD), with percutaneous endoscopic lumbar discectomy (PELD) encompassing both TELD and IELD techniques as one group—revealed distinct statistical significance in safety and complication rates.9
In the cases of TELD, notably, was found to be significantly safer than IELD, as indicated by a p < 0>
Furthermore, when comparing both endoscopic approaches as a single group under PELD, it demonstrated a higher safety profile compared to MLD, with a p value of 0.0092, underlining PELD as the safer option among the techniques evaluated. This inclusion of both TELD and IELD under the umbrella of PELD highlights the overall safety benefits of endoscopic approaches when considering the risk of complications.9 This study described also the uncommon complications documented within the scope of endoscopic spine surgery. The authors included in this section cases of hematoma in the iliopsoas, incorrect positioning of the endoscopic access system, instrument entrapment in the working channel, segmental artery injury, pneumothorax, pseudomeningocele with nerve root entrapment, discal pseudocyst, and arachnoid cyst.9
Only 3 meta-analyses indicated a significant difference in the frequency of complications favoring endoscopy, while the remaining studies did not demonstrate statistically significant differences.10,11,12
Another meta-analysis that included a total of 9 articles with 522 patients in the UPFE (Uniportal Full Endoscopy) group and 367 patients in the MIS (minimal invase surgery) group were included. The authors concluded that the UPFE decompression is associated with shorter hospital stay time and lower intraoperative blood loss and wound-related complications compared with MIS decompression for treatment of lumbar spinal stenosis patients. The postoperative clinical scores, satisfaction rate, operation time, complication rates for dural injury, epidural hematoma, and postoperative transient dysesthesia and weakness did not differ significantly between two groups.13
Other recent meta-analysis with 6 RCTs including 646 patients met selection criteria. The authors concluded with P vale < 0>
We included in this section other reference about 4 retrospective observational and 1 prospective observational study, with a total of 423 patients (183 Endo-LIF and 241 MIS-TLIF). The authors reported that the pooled data analysis revealed low heterogeneity between the studies evaluated. For the baseline characteristics including age and sex they don’t found different between the two groups. Respected to the operation time was significantly longer in Endo-LIF group with mean difference of 23.220 minutes 95% confidence interval, 10.669-35.771; p=0.001. The authors described that relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain. On the other hand, no statistically significant group difference in complication rate, hospital stay, and pseudoarthrosis rate were found. Actually Endo-LIF present a challenge, longer operation time which means a difficult learning curve and limited surgical indication.15
To increase the statistical power of the results of this studies it will be necessary larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.
• Studies that release the comparison of both techniques:
The first reference that we present in this section is a Meta-Analysis that included a total of 7 studies, with 198 patients in a uniportal endoscopy group and 185 patients in a biportal endoscopy group. The results demonstrated that the biportal endoscopy group experienced less intraoperative estimated blood loss, with statistically significant results (p = 0.01). The uniportal endoscopy group displayed significantly better recovery results in Visual Analog Scale (VAS) assessments of the back within 3 days of surgery (p = 0.04).
However, no significant differences in operation time, length of hospital stay, complication rates, Oswestry Disability Index (ODI) (within 3 months), ODI (last follow-up), VAS for back (within 3 months), VAS for
back (last follow-up), and VAS for leg (within 3 days, within 3 months, last follow-up) were identified between the two groups. The study concluded that both surgical techniques are safe and effective.16
The second meta-analysis presented in this section included 9 articles, showed that UPFE was associated with shorter operative time, less intraoperative bleeding and shorter hospital stay, whereas UBE was associated with a greater increase in postoperative dural sac area. Postoperative visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, satisfaction rates, complications, and mean number of fluoroscopic views were not dramatically dissimilar in UBE and UPFE for Lumbar degenerative disease (LDD). In the Lumbar disc herniation (LDH) subgroup, postoperative hospital stay and operative time were significantly lower in the UPFE group than in the UBE group.17
Other recent meta-analysis with 513 patients across 5 studies, comprising 246 patients in the one-hole split endoscopy (OSE) group and 267 patients in the Unilateral biportal Endoscopy (UBE) group. The findings of this meta-analysis indicated that the incision length in the OSE group was significantly shorter than that in the UBE group with a value P = 0.001. However, no statistically significant differences were observed between the two groups regarding operative duration, intraoperative blood loss, length of hospital stay, Visual Analog Scale (VAS) scores at various postoperative time points, Oswestry Disability Index (ODI) values at various postoperative time points, rates of excellent and good outcomes, sagittal translation (ST), range of motion (ROM), and complication rates. The authors of this study concluded that both techniques are safe and effective for the management of Lumbar degenerative disease (LDD), demonstrating comparable treatment outcomes. However, OSE techniques offer the advantages of smaller surgical incisions and potentially reduced trauma.18
We included also a recent meta-analysis, the authors after a preliminary selection of 388 studies from electronic databases applied the full inclusion criteria. Finally, 3 studies were included, with a total of 184 patients from 3 unique studies. Meta-analysis of visual analog scale score for low back pain and leg pain showed no significant difference at the final follow-up (P = 0.51 and P = 0.66). Oswestry disability index (ODI) score after biportal surgery was lower than uniportal surgery with a value P = 0.02. The mean operation time was similar in both groups with a P = 0.53. The UBE group was associated with a shorter length of hospital stay (P = 0.05). Complications were similar in both groups (P = 0.89). The authors of this meta-analysis concluded that with the current evidence shows no significant differences in most clinical outcomes between uniportal and biportal surgery. UBE may present in this study a better ODI score at the end of the follow-up compared to the uniportal group.19
The last study present in this section it’s also a recent meta-analysis with 5 studies including a total of 314 patients after applying the determined inclusion criteria. The UBE-TLIF group comprised 154 patients, and the Endo-TLIF group comprised 160 patients. In this meta-analysis the group of UBE-TLIF was superior to Endo-TLIF in terms of the operative time and fusion rate. There were no significant differences in the intraoperative blood loss, hospital length of stay, complication rate, visual analogue scale scores, or Oswestry disability index between the two groups.20
• UBE relevants manuscripts:
This recent meta-analysis with a total of 5 studies included in the analysis, providing 6 datasets to elucidate the UBE learning curve. 3 of the 5 studies included analyzed the learning curves using the Cumulative Sum method and identified cutoff points. 1 study plotted learning curves and determined cutoff points based on surgical time analysis, while the remaining one study (providing two datasets) plotted learning curves using the phased analysis method. The mean value of the cutoff point in terms of the number of cases required to reach proficiency in time to surgery was calculated at 37.5 cases, with a range spanning from 14 to 58 cases. The authors present a statistically significant difference in time to surgery between the late group and the early group, with the late group demonstrating a significantly reduced time to surgery (P < 0>
Other recent meta-analysis that selected 9 studies, included a total of 823 patients with a single Lumbar Spinal Stenosis (LSS) segment. All the studies included comparing UBE clinical outcomes and micro- endoscopic unilateral laminotomy for bilateral decompression (M-ULBD). The meta-analysis revealed that the UBE group had better VAS-leg and back scores in the first week postoperatively with statistically significant p value for both parameters, 1st month postoperatively p = 0.01; total p = 0.005, at the 6th month postoperatively p = 0.002; total p = 0.005, and UBE group also performed better in ODI score at 1st month postoperatively with p < 0>
In this systematic review and meta-analysis, a total of 7 studies were included. The authors concluded that the intraoperative bleeding was higher in the control group than in the UBE group with a P=0.14. The improvement of ODI score in the UBE group was significantly better with a P=0.17. There was no statistical heterogeneity in terms of postoperative complications with a P=1.00. The complication rate in the UBE group was lower with a P=1.00. In the postoperative period the VAS improvement in UBE group was significantly better with a P=0.11. The length of hospital stay in UBE group was shorter with a P<0>0.05, suggesting that this conclusion was stable.23
Another recent meta-analysis that compared Unilateral biportal endoscopy and Microdiscectomy (MD) included 7 studies. The results showed that the operation time of UBE group was shorter than that of MD with a P= 0,02. Compared with MD, the patients’ back pain was slighter on the 1st day, 1–2 months and 6 months after UBE. During the long-term follow-up, there was no significant difference in back pain between both groups. There was no significant difference in lower limb visual analogue score (VAS) score between UBE decompression and MD with P= 0.412. The results were statistically significant for the C-reactive protein (CRP) level of UBE was lower than that of MD P= 0,02. There was no significant difference in other clinical effects between the 2 groups.24
In this systematic review and meta-analysis, they began by preliminary screening 239 studies from electronic databases and, after applying the inclusion criteria, found 16 studies eligible for inclusion. These studies included a total of 1488 patients, of which 653 were in the UBE group, 570 were in the microendoscopic discectomy group, 153 were in the percutaneous endoscopic lumbar discectomy group, and 70 were in the posterior lumbar interbody fusion group. UBE was superior to microendoscopic discectomy in terms of daily Visual Analog Scale (VAS) back pain scores (p<0>
A meta-Analysis included a total of 10 papers, including 2 randomized controlled trials. In this study was included 710 patients, 348 in the UBE-LIF group and 362 in the Endo-LIF group. The results showed that the UBE-LIF group was superior to the Endo-LIF group in terms of operative time and rate of progress of surgical time for beginners. In contrast, the Endo-LIF group was superior to the UBE-LIF group in terms of hospitalization time, hidden blood loss, and TBL. They found no statistical differences between the two procedures for intraoperative bleeding, postoperative drainage, visual analog score for low back pain, Oswestry Disability Index, complications, fusion rates, and modified MacNab score excellence rates. The authors of this study concluded that postoperative pain and safety were comparable between the two endoscopic procedures. They also mention that the UBE-LIF procedure was shorter, while the Endo-LIF had less TBL and a shorter recovery time.26
Another meta-analysis included 6 high-quality case–control trials (CCTs) involving 621 patients. In this study the clinical outcomes assessment showed no statistical differences in complication rates, fusion rates, leg pain VAS scores, or ODI scores. They described that after UBE-TLIF, VAS scores for low back pain improved significantly, with less intraoperative blood loss and a shorter hospital stay. However, UBE-TLIF required a longer procedure. Even with the various limitations observed in the study as a lack of sufficient high quality randomized controlled trials (RCTs), the results of this meta-analysis suggest that UBE-TLIF is more effective than open surgery in terms of length of stay, blood loss reduction during surgery, and improved low back pain after surgery.27
| Features | Uniportal Full Endoscopy (UFE) | Unilateral Bilateral Endoscopy (UBE) |
| Number of Incisions | 1 | 2 |
| Portal Usage | One portalfor both viewingand operation | Two portals for viewing and operation |
| Cosmesis (Scarring) | Better (only one incision) | Slightly more scarring due to two incisions |
| Postoperative Recovery | Faster due toless tissue disruption | Slightly longer recovery time than UFE |
| Ergonomics | Can be challenging due to limited angles | Better ergonomics withtwo portals |
| Complexity of Surgery | Best for simpler, lesscomplex procedures | Suitable for more complex procedures |
| Learning Curve | Steeper, due to single-port technique | Steeper due to need for precision with dual portals |
| Surgeon Experience | Requires significant training | Requires advanced skill in spine surgeries, but offers better maneuverability |
| Cost | Fewertools needed, exclusive for one surgery | Use common materials |
Table 1: Comparison Summary of both endoscopic thecniques:
Conclusion:
Uniportal and biportal spine endoscopy techniques are a minimally invasive procedures that in recent years, both techniques continue to gain recognition for its potential to improve outcomes and they are safe. They presented good clinical application prospects and efficacy, with many studies reported no statistical differences in the incidence of postoperative complications between the thecniques.
The endoscopic spine surgeons can learn either method according to the surgeon's preference and the clinical situation.
The choice between UFE and UBE often depends on the surgeon’s experience, the complexity of the procedure, patient-specific factors, or available conditions.
Nevertheless, for both thecniques the evidence will be supplemented in the future by more and better quality multicenter randomized controlled trials.
Part of present and in the near future, the combination of UFE and UBE techniques with Neuronavigation, intelligent medical and surgical robotics technology is expected to promote the further development of spinal surgery.
Further technical optimization and large-scale clinical research are still needed to ensure the safety and effectiveness.
Acknowledges:
For all the patients, my colleagues during my career, and also to my family for the support.
Conflict of interest:
Not applicable.
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Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
