Preliminary clinical outcomes of unilateral biportal endoscopy for decompressing lumbar spinal stenosis

English Keywords:Lumbar spinal stenosis  Biportal  Endoscopic surgery  Preliminary follow-up

English Abstract:

  【Abstract】 Objectives: To evaluate the preliminary clinical outcomes of unilateral biportal endoscopy(UBE) unilateral laminectomy bilateral decompression(ULBD) for lumbar spinal stenosis. Methods： The data of patients with single-level central spinal stenosis or lateral recess stenosis who underwent UBE ULBD in our department from April 2020 till January 2021 and were followed up over three months were analyzed retrospectively. A total of 64 patients were included in our study, of which there were 28 with central lumbar spinal stenosis[15 males and 13 females; 57-77 years old, averaged 67.79±6.29 years; mean body mass index(BMI) 22.31±2.89kg/m2; follow-up duration 3-9 months, averaged 3.86±1.80 months] and 36 with lateral recess stenosis(17 males and 19 females; 50-79 years old, averaged 62.75±8.02 years; mean BMI 23.14±2.73kg/m2; follow-up duration 3-9 months, averaged 4.83±2.30 months). There were 14 cases of Schizas level B, 13 of level C and 1 of level D in the central lumbar spinal stenosis group, while 8 of level A, 17 of level B and 11 of level C in the lateral recess stenosis group. The visual analogue scales (VAS) for pain in back and legs, and the Oswestry disability index (ODI) of all the patients were collected before operation, on the second day after operation, at one-month, three-month and the last follow-ups. Moreover, the preoperative and postoperative area of dural sac, hemoglobin, operation time, ambulation time, and hospitalization period were recorded. Paired t-test was applied to compare the differences between preoperative and postoperative values, as well as during the follow-ups. Results: The VAS scores for back and leg pain on the next day after operation, at one-month, three-month and the last follow-up of both groups were significantly lower than those preoperatively. The ODI scores at one-month, three-month and last follow-up of both groups were significantly lower than those preoperatively. Of the central lumbar spinal stenosis group and the lateral recess stenosis group, the postoperative hemoglobin decreased by 21.54±7.24g/L and 21.00±7.67g/L, the operation time was 120.75±9.79min and 106.40±12.99min, the ambulation time was 1.61±0.63 and 1.47±0.61 days, and the hospitalization period were 4.39±1.77 and 3.69±1.70 days, respectively. The improvement rates of dural sac area of the two groups were (108.21±38.28)% and (62.20±53.10)% respectively. All central lumbar spinal stenosis cases improved to Schizas level A. 1 case in lateral recess stenosis group improved from level C to B, and all other cases improved to level A. There were no severe complications or adverse events happened. Conclusions: The UBE ULBD is an effective and safety surgery for sufficient decompression of lumbar spinal stenosis or lateral recess stenosis with certain early follow-up′s outcomes.