Frontiers | Clinical Efficacy of Unilateral Laminotomy for Bilateral Decompression (ULBD) in the Treatment of Adjacent Segment Disease after Lumbar Fusion

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2024-09-03 DOI:10.3389/fsurg.2024.1449838

Yun Xu, Yang Liu, Din Ding, Bin Ru, Quan Wan, Zhongwei Ji, Wenlong Liu, Ran Guo, Jiaqi Hu, Nannan Zhang, Langhai Xu, Shun Li, Wenjun Cai

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引用次数: 0

Abstract

ObjectiveTo assess the clinical impact of unilateral laminotomy for bilateral decompression (ULBD) in managing patients with adjacent vertebrae following lumbar fusion.MethodsA retrospective analysis was conducted on 21 patients, with a mean age of 67.4 years, who underwent ULBD for adjacent vertebra disease at our department from January 2021 to November 2023. We reviewed demographic data, surgical techniques, imaging studies, and patient-reported outcomes. The study compared Visual Analog Scale (VAS) scores, Numeric Rating Scale (NRS) scores, Japanese Orthopaedic Association (JOA) scores, Short Form-36 (SF-36) scores, and imaging outcomes before surgery, immediately post-surgery, and at 1 month, 6 months, and 12 months post-surgery.ResultsEvaluation of 21 patients with adjacent segment disease (ASD) (13 males, 8 females; mean age 67.42 years) was performed with follow-ups at various intervals post-surgery. Postoperative VAS, NRS, JOA, and SF-36 scores showed significant improvements compared to preoperative scores. Immediately after surgery, there were significant improvements in NRS score (2.76 ± 0.70 vs. 3.71 ± 0.85, P < 0.05) and JOA score (15.38 ± 1.02 vs. 9.29 ± 1.01, P < 0.05) compared to preoperative scores. Similarly, at 12 months post-surgery, significant improvements were observed in NRS score (1.52 ± 0.51 vs. 3.71 ± 0.85, P < 0.05) and JOA score (25.0 ± 1.10 vs. 9.29 ± 1.01, P < 0.05) compared to preoperative scores. The clinical satisfaction rate was 95.0% among all patients, with postoperative imaging examinations revealing a significant decompression effect. No complications were reported among the surgical patients.ConclusionsThis study suggests that endoscopic ULBD can be a safe and effective technique for managing symptomatic ASD, providing satisfactory clinical outcomes for patients with ASD. Endoscopic ULBD may serve as an alternative treatment option for ASD with lumbar stenosis.

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前沿｜单侧椎板切开双侧减压术（ULBD）治疗腰椎融合术后邻近节段疾病的临床疗效

方法对 2021 年 1 月至 2023 年 11 月期间在我科接受单侧椎板切除双侧减压术（ULBD）治疗邻近椎体疾病的 21 例患者（平均年龄 67.4 岁）进行回顾性分析。我们回顾了人口统计学数据、手术技术、影像学检查和患者报告的结果。研究比较了术前、术后即刻、术后1个月、6个月和12个月的视觉模拟量表（VAS）评分、数字评分量表（NRS）评分、日本矫形外科协会（JOA）评分、短表格-36（SF-36）评分和影像学结果。结果对21名邻近节段疾病（ASD）患者（13名男性，8名女性；平均年龄67.42岁）进行了评估，并在术后不同时间段进行了随访。与术前相比，术后的 VAS、NRS、JOA 和 SF-36 评分均有显著改善。与术前相比，术后NRS评分（2.76 ± 0.70 vs. 3.71 ± 0.85，P < 0.05）和JOA评分（15.38 ± 1.02 vs. 9.29 ± 1.01，P < 0.05）均有明显改善。同样，与术前评分相比，术后 12 个月的 NRS 评分（1.52 ± 0.51 vs. 3.71 ± 0.85，P < 0.05）和 JOA 评分（25.0 ± 1.10 vs. 9.29 ± 1.01，P < 0.05）也有明显改善。所有患者的临床满意率为 95.0%，术后影像学检查显示减压效果显著。结论这项研究表明，内镜超低压瓣膜置换术是治疗无症状 ASD 的一种安全有效的技术，能为 ASD 患者带来满意的临床疗效。内窥镜超低位腰椎间盘突出症可以作为腰椎管狭窄的 ASD 的替代治疗方案。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.