Unilateral laminotomy for bilateral decompression assisted by unilateral biportal endoscopy in the treatment of lumbar spinal stenosis

doi:10.3969/j.issn.1006-7795.2023.04.027

Abstract

Abstract: Objective To investigate the surgical safety and clinical efficacy of unilateral laminotomy for bilateral decompression (ULBD) assisted by unilateral biportal endoscopy (UBE) in the treatment of lumbar spinal stenosis (LSS). Methods 31 patients with lumbar spinal stenosis treated by UBE-assisted ULBD from July 2020 to December 2021 were analyzed retrospectively. There were L3/4 in 1 case, L4/5 in 17 cases and L5/S1 in 13 cases. The Visual Analogue Scale (VAS) for low back pain and leg pain respectively, and Oswestry Disability Index (ODI) were evaluated before operation, 1 month, 3 months and 12 months after operation. The modified MacNab criteria were used for evaluation of the clinical consequences. Lumbar X-ray in the excessive flexion and extension position were reexamined at 12 months after operation. Results All 31 patients successfully completed the operation, and the time was （101.52 ± 10.57）min. Complications included dural tears in 1 case and transient numbness of lower limbs in 1 case. The average follow-up was （19.97±4.27） months. The VAS score of low back pain decreased from 4.68 ± 1.40 before operation to 2.08 ± 0.68, 1.77 ± 0.48 and 1.36 ± 0.55 at 1 month, 3 months and 12 months after operation, respectively (P <0.05); The VAS score of leg pain decreased from 6.01 ± 1.37 before operation to 2.61 ± 0.68, 2.11 ± 0.74 and 1.67 ± 0.45 at 1 month, 3 months and 12 months after operation, respectively (P<0.05). The ODI score was 57.74 ± 10.82 before operation and decreased to 31.13 ± 3.38, 21.84 ± 3.33 and 17.06 ± 1.60 at 1 month, 3 months and 12 months after operation, respectively (P<0.05). According to the modified MacNab criteria, the final clinical outcome was excellent in 23 cases, good in 4 cases, fair in 4 cases at the follow-up of 12 months, with the excellent and good rate of 87.1%. After 12 months follow-up, no instability of surgical segments was found by lumbar X-ray in the excessive flexion and extension position. Conclusions ULBD assisted by UBE in the treatment of LSS has a satisfactory clinical effect, maintains the good lumbar stability, and has the advantages of small surgical injury and fast recovery.

Key words: unilateral biportal endoscopy (UBE), unilateral laminotomy for bilateral decompression (ULBD), lumbar spinal stenosis (LSS)

CLC Number:

R687.3

Tao Luming, Li Dongyue, Zhang Xinuo, Su Qingjun, Hai Yong. Unilateral laminotomy for bilateral decompression assisted by unilateral biportal endoscopy in the treatment of lumbar spinal stenosis[J]. Journal of Capital Medical University, 2023, 44(4): 684-689.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.04.027

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I4/684

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