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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neuromuscular Disorders and Peripheral Neuropathies
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1409088

A Comparative Analysis of Unilateral biportal endoscopic and open laminectomy in Multilevel Lumbar Stenosis

Provisionally accepted
Jianyuan Ouyang Jianyuan Ouyang 1Qiyuan Yang Qiyuan Yang 1Lanlan Chen Lanlan Chen 2Qin Li Qin Li 1Yuhao Zheng Yuhao Zheng 1Bing Tan Bing Tan 1*
  • 1 Department of Spine Surgery, Mianyang Third People's Hospital, Mianyang, China
  • 2 Department of neurology, Mianyang Third People's Hospital, Mianyang, China

The final, formatted version of the article will be published soon.

    Background:The unilateral biportal endoscopic technique is effective for single-segment cases and serves as an alternative to traditional open lumbar laminectomy, though its efficacy for multilevel cases remains unclear. Objective: To compare the clinical outcomes of unilateral biportal endoscopy (UBE) versus open lumbar decompression (OLD) for treating multilevel lumbar spinal stenosis (MLSS). Methods: This study (Feb 2019 - Dec 2023) compared Multilevel UBE surgery with OLD in 42 patients (86 segments) and 40 patients (82 segments). One-year follow-up included imaging, VAS, ODI, and ZCQ assessments, with CSA and PMA measured pre-surgery and at final follow-up. Results: Both groups mainly had adjacent surgical segments (UBE 78.6%, OLD 78.8%), with the OLD group having more bilateral decompressions (UBE 24.4%, OLD 28.0%). Preoperative imaging showed a higher prevalence of grade C stenosis in both groups (UBE 74.4%, OLD 72%). The OLD group experienced significantly more blood loss (147.63 ± 26.55 ml vs. 46.19 ± 25.25 ml, P < 0.001) and longer hospital stays (7.58 ± 1.39 days vs. 4.38 ± 1.56 days, P < 0.05) compared to the UBE group. The UBE group had less paravertebral muscle atrophy than the OLD group (3.49 ± 3.03 vs. 5.58 ± 3.00, P < 0.05).Both groups had elevated serum creatine kinase levels one day after surgery, but the UBE group's levels were significantly lower (108.1 ± 12.2 vs 364.13 ± 20.24 U/L, P < 0.05).By postoperative day 7, liver enzyme levels in the UBE group significantly dropped from preoperative levels (61.81 ± 7.14 vs 66.10 ± 8.26 U/L, p < 0.05). Both groups showed significant improvements in ODI and ZCQ scores at 1 week, 6 months, and 1 year post-operation compared to preoperative scores (p < 0.05).The study observed notable differences in VAS (2.28 ± 0.59 vs. 2.85 ± 0.74, p < 0.05) and ODI scores (36.28 ± 2.03 vs. 37.57 ± 1.98, p < 0.05) between the groups one week after surgery, with no significant changes at later follow-ups.Conclusion: UBE technique for multilevel lumbar spinal stenosis showed less intraoperative bleeding, fewer postoperative muscle complications, and facilitated early mobilization compared to OLD.

    Keywords: multilevel lumbar spinal stenosis, Unilateral biportal endoscopy, Open lumbar decompression, Spinal endoscopy, Unilateral approach bilateral decompression

    Received: 29 Mar 2024; Accepted: 14 Nov 2024.

    Copyright: © 2024 Ouyang, Yang, Chen, Li, Zheng and Tan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Bing Tan, Department of Spine Surgery, Mianyang Third People's Hospital, Mianyang, China

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