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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 London Spine Lumbar Stenosis

The article explores 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 included 274 patients who underwent MEL for symptomatic LSS with a minimum 5-year follow-up. Patients were grouped based on the presence or absence of DS and were evaluated for clinical outcomes at 1 year and > 5 years post-surgery. The results showed no significant difference in outcomes between the DS+ and DS- groups at the final follow-up. However, female sex, slip angle > 5°, and dynamic progression of Meyerding grade were identified as high-risk factors for poor long-term outcomes. The study suggests that MEL may have good results in patients with DS without dynamic instability, while women with dynamic instability may require additional fusion surgery in some cases

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised treatment hospital in UK

Published article

CONCLUSIONS: 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.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
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,

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.

Conclusions: 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.

Keywords: degenerative spondylolisthesis; lumbar fusion surgery; lumbar spinal stenosis; microendoscopic laminotomy; propensity score matching; spinal instability.

The London Spine Unit : most specialised treatment hospital in UK

Read the original publication:

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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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

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