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Published in: Journal of Orthopaedic Surgery and Research 1/2024

Open Access 01-12-2024 | Spinal Stenosis | Research article

Early efficacy observation of the unilateral biportal endoscopic technique in the treatment of multi-level lumbar spinal stenosis

Authors: Dingding Jia, Xin Qiao, Xuepan Wang, Shaoqing Li, Qiang Li, Yunbing Hao, Xiangping Peng

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

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Abstract

Background

To explore the early curative effect of unilateral biportal endoscopy (UBE) in the treatment of multi-level lumbar spinal stenosis with the help of multiple small incisions.

Methods

A retrospective analysis was performed on 26 patients with multi-level lumbar spinal stenosis treated by UBE in our hospital from August 1, 2021, to March 1, 2022. We collect patients’ basic medical records and independently design surgical incisions. The visual analog score (VAS) and Oswestry Disability Index (ODI) were compared before surgery, 7 days after surgery and 6 months after surgery. Spinal canal diameters on CT were compared before surgery and 7 days after surgery. The modified MacNab standard was used to evaluate the efficacy satisfaction at 6 months after operation.

Results

In this study, 26 patients were operated according to the predetermined surgical plan. The operative time was 145 ± 40.11 min, the intraoperative blood loss was 156.25 ± 44.32 ml, and the postoperative hospital stay was 4.79 ± 1.31 days. The VAS scores of postoperative lumbago and leg pain were lower than those before surgery (P < 0.05). The postoperative ODI score was significantly different from that before surgery (P < 0.05). The postoperative CT sagittal diameter was significantly different from that before surgery (P < 0.05). The curative effect of modified MacNab was 76.92% when followed up 7 days after surgery. The curative effect of modified MacNab was 92.31% when followed up 6 months after surgery, which was significantly improved compared with 7 days after surgery.

Conclusion

Under multiple small incision channels, UBE can effectively treat multi-level lumbar spinal stenosis, significantly relieve the clinical symptoms of patients, and significantly improve the quality of life of patients. It is a safe and feasible minimally invasive surgical treatment method for multi-level lumbar spinal stenosis.
Literature
1.
go back to reference Kim JE, Choi DJ, Park EJ. Clinical and radiological outcomes of foraminal decompression using unilateral biportal endoscopic spine surgery for lumbar foraminal stenosis. Clin Orthop Surg. 2018;10(4):439–47.CrossRefPubMedPubMedCentral Kim JE, Choi DJ, Park EJ. Clinical and radiological outcomes of foraminal decompression using unilateral biportal endoscopic spine surgery for lumbar foraminal stenosis. Clin Orthop Surg. 2018;10(4):439–47.CrossRefPubMedPubMedCentral
2.
go back to reference Cho JH, Lee JH, Song KS, et al. Treatment outcomes for patients with failed back surgery. Pain Phys. 2017;20(1):E29–43.CrossRef Cho JH, Lee JH, Song KS, et al. Treatment outcomes for patients with failed back surgery. Pain Phys. 2017;20(1):E29–43.CrossRef
3.
go back to reference Mustafa O, Ulas Y, Bulent B, et al. The effects of microdecompression on patients with lumbar degenerative spinal stenosis with or without degenerative spondylolisthesis. Turk Neurosurg. 2019;29:205–12. Mustafa O, Ulas Y, Bulent B, et al. The effects of microdecompression on patients with lumbar degenerative spinal stenosis with or without degenerative spondylolisthesis. Turk Neurosurg. 2019;29:205–12.
4.
go back to reference De Antoni DJ, Claro ML, Poehling GG, et al. Translaminar lumbar epidural endoscopy: anatomy, technique, and indications. Arthroscopy. 1996;12(3):330–4.CrossRefPubMed De Antoni DJ, Claro ML, Poehling GG, et al. Translaminar lumbar epidural endoscopy: anatomy, technique, and indications. Arthroscopy. 1996;12(3):330–4.CrossRefPubMed
5.
go back to reference Pranata R, Lim MA, Vania R, July J. Biportal endoscopic spinal surgery versus microscopic decompression for lumbar spinal stenosis: a systematic review and meta-analysis. World Neurosurg. 2020;138:e450–8.CrossRefPubMed Pranata R, Lim MA, Vania R, July J. Biportal endoscopic spinal surgery versus microscopic decompression for lumbar spinal stenosis: a systematic review and meta-analysis. World Neurosurg. 2020;138:e450–8.CrossRefPubMed
6.
go back to reference Heo DH, Lee DC, Park CK. Comparative analysis of three types of minimally invasive decompressive surgery for lumbar central stenosis: biportal endoscopy, uniportal endoscopy, and microsurgery. Neurosurg Focus. 2019;46:E9.CrossRefPubMed Heo DH, Lee DC, Park CK. Comparative analysis of three types of minimally invasive decompressive surgery for lumbar central stenosis: biportal endoscopy, uniportal endoscopy, and microsurgery. Neurosurg Focus. 2019;46:E9.CrossRefPubMed
7.
go back to reference Hwa Eum J, Hwa Heo D, Son SK, Park CK. Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. J Neurosurg Spine. 2016;24:602–7.CrossRefPubMed Hwa Eum J, Hwa Heo D, Son SK, Park CK. Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. J Neurosurg Spine. 2016;24:602–7.CrossRefPubMed
8.
go back to reference Kang T, Park SY, Kang CH, Lee SH, Park JH, Suh SW. Is biportal technique/endoscopic spinal surgery satisfactory for lumbar spinal stenosis patients?: a prospective randomized comparative study. Medicine (Baltimore). 2019;98:e15451.CrossRefPubMed Kang T, Park SY, Kang CH, Lee SH, Park JH, Suh SW. Is biportal technique/endoscopic spinal surgery satisfactory for lumbar spinal stenosis patients?: a prospective randomized comparative study. Medicine (Baltimore). 2019;98:e15451.CrossRefPubMed
9.
go back to reference Aygun H, Abdulshaf K. Unilateral biportal endoscopy versus tubular microendoscopy in management of single level degenerative lumbar canal stenosis: a prospective study. Clin Spine Surg. 2021;34(6):E323–8.CrossRefPubMedPubMedCentral Aygun H, Abdulshaf K. Unilateral biportal endoscopy versus tubular microendoscopy in management of single level degenerative lumbar canal stenosis: a prospective study. Clin Spine Surg. 2021;34(6):E323–8.CrossRefPubMedPubMedCentral
10.
go back to reference Kang TW, Park SY, Park GW, Lee SH, Park JH, Suh SW. Biportal endoscopic discectomy for high-grade migrated lumbar disc herniation. J Neurosurg Spine. 2020;15(3):1–6. Kang TW, Park SY, Park GW, Lee SH, Park JH, Suh SW. Biportal endoscopic discectomy for high-grade migrated lumbar disc herniation. J Neurosurg Spine. 2020;15(3):1–6.
11.
go back to reference Jiang HW, Chen CD, Zhan BS, Wang YL, Tang P, Jiang XS. Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation: a retrospective study. J Orthop Surg Res. 2022;17(1):30.CrossRefPubMedPubMedCentral Jiang HW, Chen CD, Zhan BS, Wang YL, Tang P, Jiang XS. Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation: a retrospective study. J Orthop Surg Res. 2022;17(1):30.CrossRefPubMedPubMedCentral
12.
go back to reference Yang JC, Kim SG, Kim TW, et al. Analysis of factors contribu ting to postoperative spinal instability after lumbar decompression for spinal stenosis. Korean J Spine. 2013;10(3):149–54.CrossRefPubMedPubMedCentral Yang JC, Kim SG, Kim TW, et al. Analysis of factors contribu ting to postoperative spinal instability after lumbar decompression for spinal stenosis. Korean J Spine. 2013;10(3):149–54.CrossRefPubMedPubMedCentral
13.
go back to reference Park JH, Jang JW, Park WM, Park CW. Contralateral keyhole biportal endoscopic surgery for ruptured lumbar herniated disc: a technical feasibility and early clinical outcomes. Neurospine. 2020;17(Suppl 1):S110–9.CrossRefPubMedPubMedCentral Park JH, Jang JW, Park WM, Park CW. Contralateral keyhole biportal endoscopic surgery for ruptured lumbar herniated disc: a technical feasibility and early clinical outcomes. Neurospine. 2020;17(Suppl 1):S110–9.CrossRefPubMedPubMedCentral
15.
go back to reference Min WK, Kim JE, Choi DJ, Park EJ, Heo J. Clinical and radiological outcomes between biportal endoscopic decompression and microscopic decompression in lumbar spinal stenosis. J Orthop Sci. 2020;25:371–8.CrossRefPubMed Min WK, Kim JE, Choi DJ, Park EJ, Heo J. Clinical and radiological outcomes between biportal endoscopic decompression and microscopic decompression in lumbar spinal stenosis. J Orthop Sci. 2020;25:371–8.CrossRefPubMed
16.
go back to reference Choi DJ, Choi CM, Jung JT, et al. Learning curve associated with complications in biportal endoscopic spinal surgery: challenges andstrategies. Asian Spine J. 2016;10(4):624–9.CrossRefPubMedPubMedCentral Choi DJ, Choi CM, Jung JT, et al. Learning curve associated with complications in biportal endoscopic spinal surgery: challenges andstrategies. Asian Spine J. 2016;10(4):624–9.CrossRefPubMedPubMedCentral
17.
go back to reference Kim JE, Choi DJ. Clinical and radiological outcomes of unilateral biportal endoscopic decompression by 30° arthroscopy in lumbar spinal stenosis: minimum 2-year follow-up. Clin Orthop Surg. 2018;10(3):328–36.CrossRefPubMedPubMedCentral Kim JE, Choi DJ. Clinical and radiological outcomes of unilateral biportal endoscopic decompression by 30° arthroscopy in lumbar spinal stenosis: minimum 2-year follow-up. Clin Orthop Surg. 2018;10(3):328–36.CrossRefPubMedPubMedCentral
19.
go back to reference Pao JL, Chen WC, Chen PQ. Clinical outcomes of microendoscopic decompressive laminotomy for degenerative lumbar spinal stenosis. Eur Spine J. 2009;18(5):672–8.CrossRefPubMedPubMedCentral Pao JL, Chen WC, Chen PQ. Clinical outcomes of microendoscopic decompressive laminotomy for degenerative lumbar spinal stenosis. Eur Spine J. 2009;18(5):672–8.CrossRefPubMedPubMedCentral
20.
go back to reference Turner JA, Ersek M, Herron L, et al. Surgery for lumbar spinal stenosis. Attempted meta-analysis of the literature. Spine. 1992;17(1):1–8.CrossRefPubMed Turner JA, Ersek M, Herron L, et al. Surgery for lumbar spinal stenosis. Attempted meta-analysis of the literature. Spine. 1992;17(1):1–8.CrossRefPubMed
21.
go back to reference Lee HG, Kang MS, Kim SY, et al. Dural injury in unilateral biportal endoscopic spinal surgery. Glob Spine J. 2021;11(6):845–51.CrossRef Lee HG, Kang MS, Kim SY, et al. Dural injury in unilateral biportal endoscopic spinal surgery. Glob Spine J. 2021;11(6):845–51.CrossRef
23.
go back to reference Park JH, Jang JW, Park WM, et al. Contralateral keyhole biportal endoscopic surgery for ruptured lumbar herniated disc: a technical feasibility and early clinical outcomes. Neurospine. 2020;17(Suppl 1):S110–9.CrossRefPubMedPubMedCentral Park JH, Jang JW, Park WM, et al. Contralateral keyhole biportal endoscopic surgery for ruptured lumbar herniated disc: a technical feasibility and early clinical outcomes. Neurospine. 2020;17(Suppl 1):S110–9.CrossRefPubMedPubMedCentral
24.
go back to reference Lin G-X, Huang P, Kotheeranurak V, Park C-W, Heo D-H, Park C-K, et al. A systematic review of unilateral biportal endoscopic spinal surgery: preliminary clinical results and complications. World Neurosurg. 2019;125:425–32.CrossRefPubMed Lin G-X, Huang P, Kotheeranurak V, Park C-W, Heo D-H, Park C-K, et al. A systematic review of unilateral biportal endoscopic spinal surgery: preliminary clinical results and complications. World Neurosurg. 2019;125:425–32.CrossRefPubMed
25.
go back to reference Pan M, Li Q, Li S, Mao H, Meng B, Zhou F, et al. Percutaneous endoscopic lumbar discectomy: indications and complications. Pain Phys. 2020;23(1):49–56. Pan M, Li Q, Li S, Mao H, Meng B, Zhou F, et al. Percutaneous endoscopic lumbar discectomy: indications and complications. Pain Phys. 2020;23(1):49–56.
26.
go back to reference Park H-J, Kim S-K, Lee S-C, Kim W, Han S, Kang S-S. Dural tears in percutaneous biportal endoscopic spine surgery: anatomical location and management. World Neurosurg. 2020;136:e578–85.CrossRefPubMed Park H-J, Kim S-K, Lee S-C, Kim W, Han S, Kang S-S. Dural tears in percutaneous biportal endoscopic spine surgery: anatomical location and management. World Neurosurg. 2020;136:e578–85.CrossRefPubMed
27.
go back to reference Kim HS, Raorane HD, Wu PH, Heo DH, Sharma SB, Jang I-T. Incidental durotomy during endoscopic stenosis lumbar decompression: incidence, classification, and proposed management strategies. World Neurosurg. 2020;139:e13-22.CrossRefPubMed Kim HS, Raorane HD, Wu PH, Heo DH, Sharma SB, Jang I-T. Incidental durotomy during endoscopic stenosis lumbar decompression: incidence, classification, and proposed management strategies. World Neurosurg. 2020;139:e13-22.CrossRefPubMed
Metadata
Title
Early efficacy observation of the unilateral biportal endoscopic technique in the treatment of multi-level lumbar spinal stenosis
Authors
Dingding Jia
Xin Qiao
Xuepan Wang
Shaoqing Li
Qiang Li
Yunbing Hao
Xiangping Peng
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-024-04575-5

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