Outcome analysis of lumbar endoscopic unilateral laminotomy for bilateral decompression in patients with degenerative lumbar central canal stenosis

被引：11
|
作者：
Wu, Meng-Huang [1 ,2 ]
Wu, Po-Chien [3 ]
Lee, Ching-Yu [1 ,2 ,4 ]
Lin, Yen-Kuang [5 ]
Huang, Tsung-Jen [1 ,2 ]
Lin, Cheng-Li [6 ,7 ,8 ]
Lin, Chang-Hao [9 ]
Huang, Yi-Hung [6 ,9 ]
机构：
[1] Taipei Med Univ Hosp, Dept Orthoped, Taipei 11031, Taiwan
[2] Taipei Med Univ, Coll Med, Sch Med, Dept Orthopaed, Taipei 11031, Taiwan
[3] Taipei Vet Gen Hosp, Dept Med Educ, Taipei 11217, Taiwan
[4] Chang Gung Univ, Coll Med, Grad Inst Clin Med Sci, Taoyuan 33302, Taiwan
[5] Taipei Med Univ, Res Ctr Biostat, Taipei 11031, Taiwan
[6] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Orthopaed Surg, Tainan 70101, Taiwan
[7] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Skeleton Mat & Biocompatibil Core Lab, Res Ctr Clin Med,Coll Med, Tainan 70101, Taiwan
[8] Natl Cheng Kung Univ, Med Device Innovat Ctr MDIC, Tainan 70101, Taiwan
[9] Ditmanson Med Fdn Chia Yi Christian Hosp, Dept Orthopaed, 539 Zhongxiao Rd, Chiayi 60002, Taiwan
来源：
SPINE JOURNAL | 2021年 / 21卷 / 01期
关键词：
Degenerative lumbar central canal stenosis; Lumbar endoscopic unilateral laminotomy for bilateral decompression; Modified Macnab outcome scale; Oswestry disability index score; Outcome; Scoliosis; Spondylolisthesis; Visual analog scale; PRESERVING-INTERLAMINAR-DECOMPRESSION; MINIMALLY INVASIVE DECOMPRESSION; SPINAL STENOSIS; CLINICAL-OUTCOMES; SURGERY; COMPLICATIONS; LAMINECTOMY; DISKECTOMY; MANAGEMENT; MORPHOLOGY;
D O I：
10.1016/j.spinee.2020.08.010
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
BACKGROUND CONTEXT: Lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) has been reported as an alternative treatment for degenerative lumbar central canal stenosis (DLCS). PURPOSE: To investigate the outcomes of LE-ULBD for different types of DLCS, including simple DLCS, DLCS with degenerative spondylolisthesis (DSL), and DLCS with degenerative scoliosis (DSC). STUDY DESIGN/SETTING: Prospective cohort study. PATIENT SAMPLE: One-hundred sixteen patients with DLCS who underwent LE-ULBD at a spine center from April 2015 to June 2017 were enrolled in this study. OUTCOME MEASURES: Operative time, postoperative duration of hospitalization, and clinical outcomes (Oswestry disability index [ODI], visual analog scale [VAS], and modified Macnab outcome scale), and adverse events. METHODS: A comparative analysis was performed evaluating medical records, radiological studies, and patient reported outcomes including ODI score, VAS scores and modified Macnab outcome scales in patients who underwent LE-ULBD. Data were prospectively collected at preoperative, postoperative 3-, 6-, 12-, 24-month to assess clinical and radiological outcomes and complications. RESULTS: The study analyzed 106 patients (45 men and 61 women, with a mean age of 69.5 years); 40 (37.8%) had simple DLCS, 41 (38.7%) had DLCS with DSL, and 25 (23.5%) had DLCS with DSC. The mean follow-up period was 33.3 months. The mean preoperative and postoperative follow-up ODI score and VAS scores for leg and back pain showed significant improvement in all time points. No significant difference was found among different pathologies in terms of VAS scores for back and leg pain, ODI scores and modified Macnab outcome scales at all follow-up periods. CONCLUSIONS: LE-ULBD is a feasible treatment method for DLCS. It did not result in worse outcomes in cases with DLCS with DSL or DLCS with DSC as compared with cases with simple DLCS. (C) 2020 Elsevier Inc. All rights reserved.
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页码：122 / 133
页数：12
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