Early Clinical and Radiologic Evaluation of Endoscopic Unilateral Laminectomy for Bilateral Decompression in Degenerative Lumbar Spinal Stenosis: A Retrospective Study.

Abstract

Background: Endoscopic unilateral laminectomy for bilateral decompression (ULBD) is gaining attention as a minimally invasive procedure for treating spinal stenosis. However, comprehensive studies on its outcomes remain limited.

Purpose: This study aims to evaluate the changes in radiologic parameters and clinical outcomes associated with endoscopic ULBD for treating spinal stenosis.

Methods: A retrospective study was conducted on 53 patients with central lumbar spinal stenosis who underwent endoscopic ULBD decompression surgery. Pre- and postoperative visual analog scale and Oswestry Disability Index scores were collected to assess the impact on activities of daily living. Parameters such as operation time, intraoperative blood loss, postoperative drainage volumes (first and second day), total hospital stay, and postoperative hospital stay were recorded. Additionally, pre- and postoperative imaging changes were documented, and MacNab functional scores were evaluated at 6 months postoperatively to assess clinical efficacy.

Results: No nerve injuries occurred during the operation. Two cases of cerebrospinal fluid leakage were successfully treated with pressure dressings, and no postoperative complications such as incision infection or dehiscence were observed. At 6-month follow-up, postoperative visual analog scale scores and Oswestry Disability Index showed significant improvement compared with preoperative levels (P < 0.05). Postoperative lumbar computed tomography images revealed a statistically significant enlargement in the anterior-posterior diameter of the spinal canal and the diameter of the bilateral lateral recesses (P < 0.05). All patients experienced either improvement or resolution of clinical symptoms. The MacNab functional scores at the 6-month follow-up indicated excellent outcomes in 37 cases, good in 15 cases, and fair in 1 case, resulting in an overall good rate of 98.11%.

Conclusions: This study demonstrates that endoscopic ULBD can provide favorable outcomes for single-segment central lumbar spinal stenosis under local anesthesia at a relatively low cost.