Unilateral microscopic approach for lumbar spinal stenosis decompression: a scoping review

Moughal, Saad; Quaye, Michael C.; Wahab, Salima; Hempenstall, Jonathan; Griffith, Colin; Harvey, Jason; Giannoulis, Kyriakos D.; McGillion, Stephen; Shenouda, Emad; Brooke, Nicholas; Nader-Sepahi, Ali; Dare, Christopher J.; Shtaya, Anan

doi:10.1007/s00586-022-07461-y

Cited by 3 publications

(2 citation statements)

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“…A recent review by Moughal et al underscored ULBD’s preservation of the osteoligamentous complex, suggesting shorter operating times, less blood loss, and comparable clinical outcomes to classical laminectomy. However, the review highlights challenges in drawing universally acceptable conclusions due to the retrospective nature or lack of comparison groups in most studies [ 26 ]. Ulrich et al compared ULBD with the standard open midline approach for bilateral decompression, concluding that both approaches offered effective treatment results at the 3-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Laminotomy can be performed unilaterally and bilaterally. Microscopic unilateral laminotomy for bilateral decompression (ULBD) is a minimally invasive technique that, in addition to treating symptoms and improving function, is suggested to shorten operating time, prevent surgical complications, and reduce instability by preserving the facet joints [ 9 – 11 ]. These claims have been substantiated by many studies showing that ULBD provides satisfactory symptomatic and functional improvement in the short, medium, and long term, with a low risk of complications in patients with LSS [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

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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%