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Comparative Analysis of Microendoscopic and Open Laminectomy for Single-Level Lumbar Spinal Stenosis at L1-L2 or L2-L3 – Lumbar Spinal Stenosis

This article compares the surgical outcomes and radiographic evaluations of microendoscopic laminectomy (MEL) and open laminectomy for single-level decompression cases at L1-L2 or L2-L3 for lumbar spinal stenosis (LSS). The study analyzed patients from 12 spine centers and compared their preoperative and postoperative outcomes. The results showed that the MEL group had significantly improved postoperative EQ-5D values compared to the open group, indicating potential advantages for the MEL approach. It also found that the MEL group had a lower facet preservation rate, while the open group had a higher incidence of retrolisthesis. Overall, the study suggests that while the surgical outcomes were similar between the two approaches, the MEL group showed potential benefits in EQ-5D scores without higher postoperative instability rates

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top day surgery spinal centre in UK

Published article

CONCLUSION: Although overall surgical outcomes were similar, the MEL group demonstrated potential advantages in enhancing EQ-5D scores. The MEL group’s lower facet preservation rate did not translate into a higher postoperative instability rate.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
World Neurosurg. 2023 Dec 22:S1878-8750(23)01842-9. doi: 10.1016/j.wneu.2023.12.109. Online ahead of print.ABSTRACTBACKGROUND: Several reports have highlighted comparable surgical outcomes between microendoscopic laminectomy (MEL) and open laminectomy (open) for lumbar spinal stenosis (LSS). However, the unilateral approach in MEL may present challenges for the upper lumbar levels, where facet joints are located deeper inside. Our objective was,

World Neurosurg. 2023 Dec 22:S1878-8750(23)01842-9. doi: 10.1016/j.wneu.2023.12.109. Online ahead of print.

ABSTRACT

BACKGROUND: Several reports have highlighted comparable surgical outcomes between microendoscopic laminectomy (MEL) and open laminectomy (open) for lumbar spinal stenosis (LSS). However, the unilateral approach in MEL may present challenges for the upper lumbar levels, where facet joints are located deeper inside. Our objective was to compare surgical outcomes and radiographic evaluations for single-level decompression cases at L1-L2 or L2-L3 between MEL and open laminectomy.

METHODS: We analyzed patients who underwent single-level decompression for upper LSS at 12 distinguished spine centers from April 2017 to September 2021. Baseline demographics, preoperative, and 1-year postoperative patient-reported outcomes (PROs), along with imaging parameters, were compared between the MEL and open groups. To account for potential confounding, patients’ backgrounds were adjusted using the inverse probability weighting method based on propensity scores.

RESULTS: Among the 2487 patients undergoing decompression surgery, 118 patients (4.7%) underwent single-level decompression at L1-L2 or L2-L3. Finally, 80 patients (51 in the MEL group, 29 in the open group) with postoperative data were deemed eligible for analysis. The MEL group exhibited significantly improved postoperative EQ-5D values compared to the open group. Additionally, the MEL group showed a lower facet preservation rate according to computed tomography examination, whereas the open group had a higher incidence of retrolisthesis.

CONCLUSION: Although overall surgical outcomes were similar, the MEL group demonstrated potential advantages in enhancing EQ-5D scores. The MEL group’s lower facet preservation rate did not translate into a higher postoperative instability rate.

PMID:38143029 | DOI:10.1016/j.wneu.2023.12.109

The London Spine Unit : top day surgery spinal centre in UK

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Comparative Analysis of Microendoscopic and Open Laminectomy for Single-Level Lumbar Spinal Stenosis at L1-L2 or L2-L3

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World Neurosurg. 2023 Dec 22:S1878-8750(23)01842-9. doi: 10.1016/j.wneu.2023.12.109. Online ahead of print.ABSTRACTBACKGROUND: Several reports have highlighted comparable surgical outcomes between microendoscopic laminectomy (MEL) and open laminectomy (open) for lumbar spinal stenosis (LSS). However, the unilateral approach in MEL may present challenges for the upper lumbar levels, where facet joints are located deeper inside. Our objective was

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