Clinical efficacy and safety of endoscopic unilateral laminotomy and bilateral decompression for patients with lumbar spinal stenosis

WANG Yong-kang

doi:10.13798/j.issn.1009-153X.2023.12.004

Abstract：Objective To investigate the safety and efficacy of endoscopic unilateral laminotomy and bilateral decompression(Endo-ULBD)for patients with lumbar spinal stenosis(LSS).Methods The clinical data of 46 patients with LSS treated with Endo-ULBD from June 2020 to June 2022 were retrospectively analyzed.Visual analogue scale(VAS)score and Oswestry disability index(ODI)were used to evaluate the clinical efficacy before surgery and 1 d,3 months,6 months and 12 months after surgery.Modified MacNab score was used to evaluate the excellent and good rate.Results All patients were operated successfully.The operation time was 50～90 min,and the average time was(60.23±12.95)min.Intraoperative blood loss was 15～40 ml,with an average of(21±4.21)ml.Postoperative hospitalization days ranged from 3 to 8 days,with an average of(5.2±1.58)days.The average follow-up time was(14±8.45)months(range,10～24 months).The ODI was significantly lower 1 day after surgery than that before surgery(P＜0.001),and the ODIs were dignificantly lower 3,6 and 12 months after surgery than 1 d day after surgery(P＜0.05).The lumbar and the leg VAS scores were significantly decreased 1 day after surgery(P＜0.05).The leg VAS score was significantly lower 3,6 and 12 months after surgery than that 1 day after surgery(P＜0.05),but the lumbar VAS score did not significantly change 3,6 and 12 months after surgery(P＞0.05).At the last follow-up,the excellent and good rate was 91.3％ according to the MacNab standard.Postoperative CT,MRI and X-ray examination showed that the spinal stenoses were significantly improved.Transient nerve injury occurred in 1 patient,dural sac tear injury in 1 and recurrence in 1.The complication rate was 6.5％.Conclusions Endo-ULBD can effectively decompress lumbar spinal canal and is a safe and effective surgical method for patients with LSS.