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Lumbar Endoscopic Unilateral Laminotomy With Bilateral Decompression Surgery in Severe Lumbar Stenosis Under Electrophysiological Monitoring-Focused on Full-Visualized Trephine/Osteotome – Lumbar Spinal Stenosis

The article titled “Safety and Efficacy of Full-Visualized Trephine/Osteotome in Lumbar Endoscopic Unilateral Laminotomy with Bilateral Decompression (LE-ULBD) Surgery for Severe Lumbar Stenosis” explores the use of a full-visualized trephine/osteotome in LE-ULBD surgery for severe lumbar stenosis. The study included 57 patients who underwent the surgery and were divided into two groups: drill and trephine. The results showed significant improvement in pain and disability scores in both groups. The trephine group had a shorter operative duration compared to the drill group. There were no significant differences in electrophysiological monitoring, postoperative outcomes, and complications between the two groups. The study concludes that full-visualized trephine/osteotome is a convenient, safe, and efficient tool in LE-ULBD surgery for lumbar stenosis patients, offering a new option in treatment

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

Published article

CONCLUSION: Full-visualized trephine/osteotome has been approved to be convenient, safe and efficient in our study, which combined with translaminar inside-out technique and EMG monitoring especially free-EMG may offer a new choice in LE-ULBD surgery for lumbar stenosis patients.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Neurospine. 2023 Sep;20(3):1040-1046. doi: 10.14245/ns.2346624.312. Epub 2023 Sep 30.ABSTRACTOBJECTIVE: Although endoscopic drill has the advantages in manipulation and hemostasis, whose low efficiency and blurred vision reduce the efficacy of lumbar endoscopic unilateral laminotomy with bilateral decompression (LE-ULBD). The present study was designed to evaluate the safety and efficacy of full-visualized trephine/osteotome in the LE-ULBD surgery,

Neurospine. 2023 Sep;20(3):1040-1046. doi: 10.14245/ns.2346624.312. Epub 2023 Sep 30.

ABSTRACT

OBJECTIVE: Although endoscopic drill has the advantages in manipulation and hemostasis, whose low efficiency and blurred vision reduce the efficacy of lumbar endoscopic unilateral laminotomy with bilateral decompression (LE-ULBD). The present study was designed to evaluate the safety and efficacy of full-visualized trephine/osteotome in the LE-ULBD surgery for severe lumbar stenosis.

METHODS: Fifty-seven severe lumbar stenosis patients who underwent LE-ULBD between January 2020 to January 2023 were enrolled, who were divided into drill and visualized trephine groups. The medical records including demographics, operative duration, intraoperative electrophysiological findings, postoperative hospital stay or hospital stay, postoperative outcomes and complications were retrospectively reviewed and analyzed.

RESULTS: A total of 57 patients included 15 in drill and 42 in trephine group were enrolled in the study. There was significant difference in the pre- and postoperative visual analogue scale and Oswestry Disability Index scores in both groups (p < 0.05). The mean operative duration in the trephine group (101.05 ± 12.18 minutes) was shorter than that in the drill group (134.67 ± 9.68 minutes) (p < 0.05). There was no statistical difference between the 2 groups in electrophysiological monitoring, posthospital stays, postoperative outcomes and complications. Abnormal free-electromyography (EMG) were recorded in 2 (13.3%) and 5 patients (11.9%) in the drill and trephine group. Intraoperative somatosensory evoked potential changes occurred in 3 (20%) and 3 patients (7.1%) in the drill and trephine group and all patients recovered immediately when surgery ended. No serious complications and recurrence occurred in all the patients.

CONCLUSION: Full-visualized trephine/osteotome has been approved to be convenient, safe and efficient in our study, which combined with translaminar inside-out technique and EMG monitoring especially free-EMG may offer a new choice in LE-ULBD surgery for lumbar stenosis patients.

PMID:37798996 | DOI:10.14245/ns.2346624.312

The London Spine Unit : most established spine clinic in London

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Lumbar Endoscopic Unilateral Laminotomy With Bilateral Decompression Surgery in Severe Lumbar Stenosis Under Electrophysiological Monitoring-Focused on Full-Visualized Trephine/Osteotome

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Neurospine. 2023 Sep;20(3):1040-1046. doi: 10.14245/ns.2346624.312. Epub 2023 Sep 30.ABSTRACTOBJECTIVE: Although endoscopic drill has the advantages in manipulation and hemostasis, whose low efficiency and blurred vision reduce the efficacy of lumbar endoscopic unilateral laminotomy with bilateral decompression (LE-ULBD). The present study was designed to evaluate the safety and efficacy of full-visualized trephine/osteotome in the LE-ULBD surgery

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