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J Neurol Surg A Cent Eur Neurosurg
DOI: 10.1055/a-2281-2135
Original Article

Early Clinical and Radiologic Evaluation of Unilateral Biportal Endoscopic Unilateral Laminotomy and Bilateral Decompression in Degenerative Lumbar Spinal Stenosis: A Retrospective Study

Jianjian Yin   *
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
,
Tao Ma   *
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
,
Gongming Gao
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
,
Qi Chen
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
,
Luming Nong
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, China
› Author Affiliations Funding This study was supported by General Project of Jiangsu Provincial Department of Health (H2019025); Changzhou High-Level Medical Talents Training Project; Six Talent Peaks Project, Jiangsu Provincial Finance Department (WSW-186); and Jiangsu Provincial Social Development Project (BE2020650).
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Abstract

Background The aim of this study is to evaluate the changes in radiologic parameters and clinical outcomes following unilateral biportal endoscopic unilateral laminotomy and bilateral decompression (UBE ULBD) for treatment of central lumbar spinal stenosis.

Methods Forty-one central lumbar spinal stenosis patients who underwent UBE ULBD were enrolled from April 2021 to February 2023. Visual analog scale (VAS) for back pain and leg pain, Oswestry Disability Index (ODI) score, and the modified MacNab criteria were assessed preoperatively and postoperatively. The preoperative and postoperative cross-sectional area of the spinal canal (CSAC), anteroposterior diameter, horizontal width, and ipsilateral and contralateral lateral recess height were calculated from axial computed tomography (CT) scans. Percentage of facet joint preservation measured on axial CT scans was obtained preoperation and postoperation.

Results The VAS for back and leg pain improved from 7.24 ± 0.80 and 7.59 ± 0.59 preoperatively to 2.41 ± 0.55 and 2.37 ± 0.62 (p < 0.05) postoperatively and 1.37 ± 0.54 and 1.51 ± 0.55 at the last follow-up (p < 0.05). For ODI, improvement from 60.37 ± 4.44 preoperatively to 18.90 ± 4.66 (p < 0.05) at the last follow-up was observed. CT scans demonstrated that the postoperative CSAC increased significantly from 287.84 ± 87.81 to 232.97 ± 88.42 mm (p < 0.05). The mean postoperative anteroposterior diameter and horizontal width increased significantly from 18.01 ± 3.13 and 19.57 ± 3.80 to 22.19 ± 4.56 and 21.04 ± 3.72 mm, respectively (p < 0.05). The ipsilateral lateral recess height and contralateral lateral recess height were 3.39 ± 1.12 and 3.20 ± 1.14 mm preoperatively and 4.03 ± 1.37 and 3.83 ± 1.32 mm (p < 0.05) postoperatively, with significant differences. The ipsilateral and contralateral facet joint preservations were 88.17 and 93.18%, respectively.

Conclusion The UBE ULBD surgery is a safe and effective treatment for central lumbar spinal stenosis, associated with significant improvement in clinical outcomes and radiologic parameters. Studies with larger samples and longer follow-up periods are needed for further research.

Keywords

lumbar spinal stenosis - unilateral biportal endoscopic - unilateral laminotomy bilateral decompression - radiologic parameter

Authors' Contributions

J.J.Y. and L.M.N. contributed to the conception and design of the study, and gave final approval of the version to be published. J.J.Y. and T.M. contributed to acquisition of data and analysis and interpretation of data. G.M.G. and Q.C. contributed to drafting and revising the article. All the authors have read and approved the manuscript.


Availability of Data and Materials

The datasets supporting the conclusions of this article are included within the article. The raw data are available upon reasonable request from the corresponding author.


Ethics Approval and Consent to Participate

This study was approved by The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University Institutional Review Board (IRB), and due to the retrospective nature of the study, informed consent was waived by institute review board under ethics approval and consent to participate section. All procedures performed in this study were in accordance with the ethical standards of the national research committee.


* Jianjian Yin and Tao Ma are co-first authors.




Publication History

Received: 17 November 2023

Accepted: 04 March 2024

Accepted Manuscript online:
05 March 2024

Article published online:
10 May 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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