Evaluation of the efficacy of unilateral biportal endoscopic lamina osteotomy replantation assisted by ultrasonic bone scalpel in the treatment of lumbar infectious spondylitis.

Abstract

Objective: To analyze the clinical efficacy of ultrasonic bone scalpel (UBS)-assisted unilateral biportal endoscopic lamina osteotomy replantation (ULOR) for treating lumbar infectious spondylitis (LIS).

Methods: We conducted a retrospective analysis of patients with LIS who had therapy with UBS-assisted ULOR at our hospital between January 2020 and May 2023. A total of 17 instances matched the inclusion criteria, consisting of 7 females and 10 males. The UBS was utilized during surgery to extract the lamina completely followed by large bone grafting to fuse the cleaned intervertebral space. The study recorded and analyzed various parameters in the included patients before and after surgery.

Results: All 17 patients underwent a successful operation with an average duration of 136.82 ± 21.35 minutes, average blood loss of 77.43 ± 10.19 ml, and an average follow-up period of 18.55 ± 3.47 months. Following the surgical intervention, the patients experienced a substantial improvement in their clinical symptoms, accompanied by a significant drop in WBC, ESR, and CRP levels (all P<0.001). The postoperative VAS scores and ODI showed considerable improvement (both P<0.001). The postoperative Cobb angle and intervertebral space height were significantly corrected (P<0.001). At the last follow-up, the success rate of lumbar fusion was 100% and there were no instances of infection recurring.

Conclusion: The use of ULOR, with assistance from UBS, for the treatment of LIS has proven to be beneficial. It provides significant relief from symptoms and corrects lumbar deformity. This surgical procedure is both effective and safe.