Full-endoscopic versus microscopic unilateral laminotomy for bilateral decompression of lumbar spinal stenosis at L4–L5: comparative study

Chen, Kuo-Tai; Choi, Kyung-Chul; Shim, Hyeong-Ki; Lee, Dong Chan; Kim, Jin-Sung

doi:10.1007/s00264-022-05549-0

Cited by 16 publications

(13 citation statements)

References 31 publications

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“…Cheb et al compared full endoscopic laminotomy and ULBD for bilateral decompression of the L4–L5 LSS. They demonstrated that the endoscopic approach was comparable to ULBD in terms of clinical and radiological outcomes, with improved recovery for single-level LSS, and could further reduce tissue damage and accelerate postoperative recovery [ 36 ]. ULBD may have the advantage of shorter operative time compared to conventional laminectomy in terms of decompression in single-level degenerative LSS, but this advantage does not appear to translate to superiority in terms of back pain, functional outcome, and quality of life [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study to Compare the Effectiveness of Minimally Invasive Microscopic Unilateral Laminotomy with Microscopic Bilateral Laminotomy for Bilateral Decompression in the Early Postoperative Period in 142 Patients with Single-Level Lumbar Spinal Stenosis

Gülensoy,

Şimşek

2024

Med Sci Monit

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Background We aimed to compare the effectiveness of microscopic unilateral laminotomy for bilateral decompression (ULBD) and microscopic bilateral laminotomy for bilateral decompression (BLBD) in the early postoperative period among patients with single-level lumbar spinal stenosis (LSS). Material/Methods A retrospective cohort study was conducted on patients with LSS who underwent ULBD or BLBD between January 2020 and December 2023, including 94 patients who underwent ULBD and 58 who underwent BLBD. Patient demographics, comorbidities, smoking status, and data related to LSS were reviewed. Preoperative and postoperative assessments on day 10 included back pain visual analog scale (VAS), walking distance, and Odom criteria. Disability was evaluated using the self-assessment Oswestry Disability Index (ODI) preoperatively and on day 30. Additionally, wound infection, postoperative modified MacNab criteria, and pain (back, leg, and hip) were recorded. Results Age and sex were similar in the 2 groups. Both surgeries significantly reduced low back pain, increased walking distance, and improved Odom category on day 10, compared with baseline ( P <0.001 for all). A significant decrease in 30-day ODI, compared with baseline, was observed in both groups ( P <0.001 for both). The ULBD group had a significantly higher percentage of patients with wound infection ( P =0.014); however, the ODI score among ULBD recipients was significantly lower (better) on day 30 ( P =0.047). Conclusions ULBD may represent a less invasive, more effective, and safer surgical alternative than BLBD and classical laminectomy in patients with single-level LSS, but precautions are essential concerning wound infection.

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Section: Discussionmentioning

confidence: 99%

Retrospective Study to Compare the Effectiveness of Minimally Invasive Microscopic Unilateral Laminotomy with Microscopic Bilateral Laminotomy for Bilateral Decompression in the Early Postoperative Period in 142 Patients with Single-Level Lumbar Spinal Stenosis

Gülensoy,

Şimşek

2024

Med Sci Monit

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“…21 Recent studies showed comparable outcomes but fewer complications and shorter hospital stay after endoscopic surgeries. 4,22,23 One study reported that full-endoscopic decompression was effective for lumbar spinal stenosis with low-grade fixed spondylolisthesis ( ≥ 3 mm without motion translation on the dynamic radiography) or mild-to-moderate scoliosis( ≥ 10° coronal Cobb angle). 24 The functional outcome was better in the endoscopic group without a higher risk of revision for fusion in the early postoperative period.…”

Section: Indications Of Ess For Lumbar Spinementioning

confidence: 99%

Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

et al. 2023

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Endoscopic spine surgery (ESS) has evolved as a safe, effective, and efficient alternative for minimally invasive spine surgery (MISS). The innovation of full-endoscopic systems makes definitive decompression surgery through different approaches feasible. The approach can be determined according to the location of the target lesion or the surgeon's preference. During the past 2 decades, ESS has expanded its indications from lumbar to cervical spines. Except for decompression, endoscopy-assisted fusion surgery is also developing. However, ESS is still evolving and has a steep learning curve. The revolution of technologies and ESS techniques will enable surgeons to treat various spinal diseases more practically. In recent years, the application of the computer-assisted navigation system and augmented reality have reformed imaging quality and interpretation. The endoscopic rhizotomy techniques have opened a new way for MISS of chronic low back pain. This review introduces the current indications of ESS and its potential future expansion.

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“…This technique has shown benefits in terms of excellent magnification, illumination, and visualization during surgery. Favorable outcomes have been observed in patients with lumbar spinal stenosis treated by a full-endoscopic technique [ 22 – 25 ], but evidence showing the benefit of full-endoscopic decompression compared to tubular-based microscopic decompression is still weak. Therefore, a randomized controlled trial is required.…”

Section: Introductionmentioning

confidence: 99%

Comparison of full-endoscopic and tubular-based microscopic decompression in patients with lumbar spinal stenosis: a randomized controlled trial

Kotheeranurak

Tangdamrongtham²,

Lin

et al. 2023

Eur Spine J

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Full-endoscopic versus microscopic unilateral laminotomy for bilateral decompression of lumbar spinal stenosis at L4–L5: comparative study

Cited by 16 publications

References 31 publications

Retrospective Study to Compare the Effectiveness of Minimally Invasive Microscopic Unilateral Laminotomy with Microscopic Bilateral Laminotomy for Bilateral Decompression in the Early Postoperative Period in 142 Patients with Single-Level Lumbar Spinal Stenosis

Retrospective Study to Compare the Effectiveness of Minimally Invasive Microscopic Unilateral Laminotomy with Microscopic Bilateral Laminotomy for Bilateral Decompression in the Early Postoperative Period in 142 Patients with Single-Level Lumbar Spinal Stenosis

Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

Comparison of full-endoscopic and tubular-based microscopic decompression in patients with lumbar spinal stenosis: a randomized controlled trial

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