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Long-term efficacy of microendoscopic laminotomy for lumbar spinal stenosis in advanced degenerative spondylolisthesis with or without dynamic spinal instability: a propensity score-matching analysis – Lumbar Fusion

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The article discusses the mid- to long-term outcomes of microendoscopic laminotomy (MEL) for lumbar spinal stenosis (LSS) with degenerative spondylolisthesis (DS) and identifies preoperative predictors of poor outcomes. The study involved 274 patients who underwent spinal MEL for symptomatic LSS, with a minimum follow-up duration of 5 years. Results showed that surgical outcomes were not significantly different between groups with and without DS at the final follow-up, but female sex, slip angle > 5°, and dynamic progression of Meyerding grade were associated with poor long-term outcomes. The study suggests that MEL may have good long-term results in patients with DS without dynamic instability, while women with dynamic instability may require additional fusion surgery in approximately 25% of cases over 5 years

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

S: MEL may have good long-term results in patients with DS without dynamic instability. Women with dynamic instability may require additional fusion surgery in approximately 25% of cases for a period of ≥ 5 years.

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J Neurosurg Spine. 2024 Apr 26:1-8. doi: 10.3171/2024.2.SPINE231075. Online ahead of print. ABSTRACT OBJECTIVE: In this study, the authors aimed to determine the mid- to long-term outcomes of microendoscopic laminotomy (MEL) for lumbar spinal stenosis (LSS) with degenerative spondylolisthesis (DS) and identify preoperative predictors of poor mid- to long-term outcomes. METHODS: The authors retrospectively reviewed,

J Neurosurg Spine. 2024 Apr 26:1-8. doi: 10.3171/2024.2.SPINE231075. Online ahead of print.

ABSTRACT

OBJECTIVE: In this study, the authors aimed to determine the mid- to long-term outcomes of microendoscopic laminotomy (MEL) for lumbar spinal stenosis (LSS) with degenerative spondylolisthesis (DS) and identify preoperative predictors of poor mid- to long-term outcomes.

METHODS: The authors retrospectively reviewed the medical records of 274 patients who underwent spinal MEL for symptomatic LSS. The minimum postoperative follow-up duration was 5 years. Patients were classified into two groups according to DS: those with DS (the DS+ group) and those without DS (the DS- group). The patients were subjected to propensity score matching based on sex, age, BMI, surgical segments, and preoperative leg pain visual analog scale scores. Clinical outcomes were evaluated 1 year and > 5 years after surgery.

RESULTS: Surgical outcomes of MEL for LSS were not significantly different between the DS+ and DS- groups at the final follow-up (mean 7.8 years) in terms of Oswestry Disability Index (p = 0.498), satisfaction (p = 0.913), and reoperation rate (p = 0.154). In the multivariate analysis, female sex (standard β -0.260), patients with slip angle > 5° in the forward bending position (standard β -0.313), and those with dynamic progression of Meyerding grade (standard β -0.325) were at a high risk of poor long-term outcomes.

S: MEL may have good long-term results in patients with DS without dynamic instability. Women with dynamic instability may require additional fusion surgery in approximately 25% of cases for a period of ≥ 5 years.

PMID:38669704 | DOI:10.3171/2024.2.SPINE231075

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Long-term efficacy of microendoscopic laminotomy for lumbar spinal stenosis in advanced degenerative spondylolisthesis with or without dynamic spinal instability: a propensity score-matching analysis

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J Neurosurg Spine. 2024 Apr 26:1-8. doi: 10.3171/2024.2.SPINE231075. Online ahead of print. ABSTRACT OBJECTIVE: In this study, the authors aimed to determine the mid- to long-term outcomes of microendoscopic laminotomy (MEL) for lumbar spinal stenosis (LSS) with degenerative spondylolisthesis (DS) and identify preoperative predictors of poor mid- to long-term outcomes. METHODS: The authors retrospectively reviewed

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