Outcomes of FETD versus UBE in the treatment of L5S1 foraminal stenosis: A comparative study

Yang, Yao-Chun; Hsieh, Min-Hong; Chien, Jui-Teng; Liu, Keng-Chang; Yang, Chang-Chen

doi:10.1016/j.heliyon.2024.e27592

Cited by 1 publication

(1 citation statement)

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“…Currently, both the two widely used coaxial endoscopy and unilateral biportal endoscopy (UBE) have their own advantages with good clinical efficacy. Compared to coaxial technique, UBE has demonstrated more flexible operations but requires larger incision and soft tissue injury ( Yang et al, 2024 ). In addition, the latest concept of enhanced recovery after surgery (ERAS) has popularized MISS techniques for treating LSS, sparking professional interest in endoscopic spinal surgery ( Kerolus et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis of endoscopic cross-overtop decompression for single-segment lumbar spinal stenosis based on real clinical cases

Ding,

Zhang,

Jiang

et al. 2024

Front. Bioeng. Biotechnol.

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Introduction: For severe degenerative lumbar spinal stenosis (DLSS), the conventional percutaneous endoscopic translaminar decompression (PEID) has some limitations. The modified PEID, Cross-Overtop decompression, ensures sufficient decompression without excessive damage to the facet joints and posterior complex integrity.Objectives: To evaluate the biomechanical properties of Cross-Overtop and provide practical case validation for final decision-making in severe DLSS treatment.Methods: A finite element (FE) model of L4-L5 (M0) was established, and the validity was verified against prior studies. Endo-ULBD (M1), Endo-LOVE (M2), and Cross-Overtop (M3) models were derived from M0 using the experimental protocol. L4-L5 segments in each model were evaluated for the range of motion (ROM) and disc Von Mises stress extremum. The real clinical Cross-Overtop model was constructed based on clinical CT images, disregarding paraspinal muscle influence. Subsequent validation using actual FE analysis results enhances the credibility of the preceding virtual FE analysis.Results: Compared with M0, ROM in surgical models were less than 10°, and the growth rate of ROM ranged from 0.10% to 11.56%, while those of disc stress ranged from 0% to 15.75%. Compared with preoperative, the growth rate of ROM and disc stress were 2.66%–11.38% and 1.38%–9.51%, respectively. The ROM values in both virtual and actual models were less than 10°, verifying the affected segment stability after Cross-Overtop decompression.Conclusion: Cross-Overtop, designed for fully expanding the central canal and contralateral recess, maximizing the integrity of the facet joints and posterior complex, does no significant effect on the affected segmental biomechanics and can be recommended as an effective endoscopic treatment for severe DLSS.

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Section: Introductionmentioning

confidence: 99%