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Early-Effectiveness Of Unilateral Biportal Endoscopic Laminectomy In Treatment Of Two-Level Lumbar Spinal Stenosis London Spine Lumbar Stenosis

The article discusses the early effectiveness of unilateral biportal endoscopy (UBE) laminectomy in the treatment of two-level lumbar spinal stenosis (LSS). The study retrospectively analyzed the clinical data of 98 patients with two-level LSS who were treated with UBE between September 2020 and December 2021. The patients had different types of stenosis, and the operative segments varied. The study recorded various parameters such as operation time, blood loss, incision length, hospital stay, ambulation time, complications, and pain levels before and after surgery. The results were evaluated using visual analogue scale (VAS) score, Oswestry disability index (ODI), and Modified MacNab criteria. Imaging examinations were also performed. The article provides insights into the early outcomes of UBE laminectomy in treating two-level LSS

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spine centre in London

Published article

UBE laminectomy is a safe and effective technique with little trauma and fast recovery for two-level LSS and the early effectiveness is satisfactory.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract in English, Chinese Objective: To analyze the early effectiveness of unilateral biportal endoscopy (UBE) laminectomy in the treatment of two-level lumbar spinal stenosis (LSS). Methods: The clinical data of 98 patients with two-level LSS treated with UBE between September 2020 and December 2021 were retrospectively analyzed. There were 53 males and 45 females with,

Abstract

Objective: To analyze the early effectiveness of unilateral biportal endoscopy (UBE) laminectomy in the treatment of two-level lumbar spinal stenosis (LSS).

Methods: The clinical data of 98 patients with two-level LSS treated with UBE between September 2020 and December 2021 were retrospectively analyzed. There were 53 males and 45 females with an average age of 59.9 years (range, 32-79 years). Among them, there were 56 cases of mixed spinal stenosis, 23 cases of central spinal canal stenosis, and 19 cases of nerve root canal stenosis. The duration of symptoms was 1.5- 10 years, with an average of 5.4 years. The operative segments were L 2, 3 and L 3, 4 in 2 cases, L 3, 4 and L 4, 5 in 29 cases, L 4, 5 and L 5, S 1 in 67 cases. All patients had different degrees of low back pain, among of which 76 cases were with unilateral lower extremity symptoms and 22 cases were with bilateral lower extremity symptoms. There were 29 cases of bilateral decompression in both segments, 63 cases of unilateral decompression in both segments, and 6 cases of unilateral decompression and bilateral decompression of each segment. The operation time, intraoperative blood loss, total incision length, hospitalization stay, ambulation time, and related complications were recorded. Visual analogue scale (VAS) score was used to assess the low back and leg pain before operation and at 3 days, 3 months after operation, and at last follow-up. The Oswestry disability index (ODI) was used to evaluate the functional recovery of lumbar spine before operation and at 3 months and last follow-up after operation. Modified MacNab criteria was used to evaluate clinical outcomes at last follow-up. Imaging examinations were performed before and after operation to measure the preservation rate of articular process, modified Pfirrmann scale, disc height (DH), lumbar lordosis angle (LLA), and cross-sectional area of the canal (CAC), and the CAC improvement rate was calculated.

Results: All patients underwent surgery successfully. The operation time was (106.7±25.1) minutes, the intraoperative blood loss was (67.7±14.2) mL, and the total incision length was (3.2±0.4) cm. The hospitalization stay was 8 (7, 9) days, and the ambulation time was 3 (3, 4) days. All the wounds healed by first intention. Dural tear occurred in 1 case during operation, and mild headache occurred in 1 case after operation. All patients were followed up 13-28 months with an average of 19.3 months, and there was no recurrence or reoperation during the follow-up. At last follow-up, the preservation rate of articular process was 84.7%±7.3%. The modified Pfirrmann scale and DH were significantly different from those before operation ( P<0.05), while the LLA was not significantly different from that before operation ( P=0.050). The CAC significantly improved ( P<0.05), and the CAC improvement rate was 108.1%±17.8%. The VAS scores of low back pain and leg pain and ODI at each time point after operation significantly improved when compared with those before operation, and the differences between each time points were significant ( P<0.05). According to the modified MacNab criteria, 63 cases were excellent, 25 cases were good, and 10 cases were fair, with an excellent and good rate of 89.8%.

UBE laminectomy is a safe and effective technique with little trauma and fast recovery for two-level LSS and the early effectiveness is satisfactory.

Purpose: To analyze the early clinical efficacy of unilateral biportal endoscopy (UBE) spinal canal decompression in the treatment of bilevel lumbar spinal stenosis (LSS). .

method: The clinical data of 98 patients with double-level LSS treated with UBE spinal canal decompression between September 2020 and December 2021 were retrospectively analyzed. There were 53 males and 45 females; their age ranged from 32 to 79 years, with an average of 59.9 years. Among them, there were 56 cases of mixed spinal canal stenosis, 23 cases of central spinal canal type, and 19 cases of nerve root canal type. The course of disease ranged from 1.5 to 10 years, with an average of 5.4 years. Surgical segment: L 2、3、L 3、4 2 cases, L 3、4、L 4、5 29 cases, L 4、5and L 5、S 1 67 cases. All patients had low back pain to varying degrees, 76 cases had unilateral lower extremity symptoms, and 22 cases had bilateral lower extremity symptoms. 29 cases underwent bilateral decompression in both segments, 63 cases underwent unilateral decompression, and 6 cases underwent unilateral and bilateral decompression respectively. The operation time, intraoperative blood loss, total incision length, hospitalization time, postoperative time to the ground and related complications were recorded. Pain Visual Analogue Scale (VAS) was used to evaluate the degree of low back pain and leg pain before operation, 3 days after operation, 3 months after operation and at the last follow-up, and the Oswestry Disability Index (ODI) was used to evaluate the degree of pain before operation and 3 months after operation and the functional improvement at the last follow-up, and the modified MacNab criteria were used to evaluate the curative effect at the last follow-up. Imaging examinations were performed before and after the operation, and the articular process retention rate on the approach side, modified Pfirrmann grade, disc height (DH), lumbar lordosis angle (LLA) and spinal canal cross-sectional area (cross-sectional area) were measured. sectional area of ​​the canal, CAC) and calculate the CAC improvement rate. .

result: All 98 patients successfully completed the operation. The operation time was (106.7±25.1) min, the intraoperative blood loss was (67.7±14.2) mL, the total incision length was (3.2±0.4) cm, and the hospital stay was 8 (7, 9) days. Landing time 3 (3, 4) d. All incisions healed by first intention. Dural tear occurred in 1 case during operation, and mild headache occurred in 1 case after operation. All patients were followed up for 13 to 28 months, with an average of 19.3 months; no recurrence or reoperation occurred during the follow-up period. At the last follow-up, the articular process retention rate on the approach side was 84.7%±7.3%. The modified Pfirrmann grade and DH were significantly different from those before operation ( P<0.05),LLA与术前比较差异无统计学意义( P=0.050); CAC was significantly improved compared with preoperative ( P<0.05),CAC改善率为108.1%±17.8%。术后各时间点腰痛和腿痛VAS评分及ODI均较术前明显改善,各时间点间两两比较差异均有统计学意义( P<0.05)。末次随访时采用改良MacNab标准评价疗效,获优63例、良25例、中10例,优良率89.8%。.

in UBE spinal canal decompression in the treatment of double-segment LSS has the advantages of less trauma, faster recovery, safe and effective operation, and satisfactory early clinical efficacy. .

Keywords: Unilateral biportal endoscopy technique; decompression; effectiveness; lumbar spinal stenosis.

The London Spine Unit : most specialised spine centre in London

Read the original publication:

Early-effectiveness of unilateral biportal endoscopic laminectomy in treatment of two-level lumbar spinal stenosis

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Abstract in English, Chinese Objective: To analyze the early effectiveness of unilateral biportal endoscopy (UBE) laminectomy in the treatment of two-level lumbar spinal stenosis (LSS). Methods: The clinical data of 98 patients with two-level LSS treated with UBE between September 2020 and December 2021 were retrospectively analyzed. There were 53 males and 45 females with

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