A Comparative Retrospective Study of UBE-ULBD Versus Open Surgery for Severe Thoracic Spinal Stenosis Caused by Ossification of Ligamentum Flavum.

Abstract

Objective: This study evaluates the safety and efficacy of UBE-ULBD for severe thoracic stenosis caused by high-occupancy TOLF.

Methods: This was a retrospective comparative cohort study. 57 patients were divided into Group A and Group B. Perioperative variables, imaging findings, and clinical outcomes were compared.

Results: Group A showed better early (1-week/1-month) back pain VAS scores (p < 0.05), but not at 3 months. Statistically significant differences (p < 0.05) were observed between groups in the following parameters: wound length (MD: -7.6, 95% CI: -7.88 to -7.32, p < 0.001); number of intraoperative fluoroscopies (MD: 2.2, 95% CI: 1.82 to 2.58, p < 0.001); time to ambulation (MD: -4.1, 95% CI: -4.34 to -3.86, p < 0.001); length of hospital stay (MD: -3.4, 95% CI: -3.97 to -2.83, p < 0.001); time to full weight-bearing (MD: -19.5, 95% CI: -20.86 to -18.14, p < 0.001); posterior bone loss rate (MD: -34.6, 95% CI: -35.78 to -32.51, p < 0.001); and incidence of cerebrospinal fluid leakage (RD: -19.6%, 95% CI: -36.9% to -2.3%, p = 0.033). No other significant differences were found.

Conclusions: In this retrospective cohort, UBE-ULBD provided similar neurological recovery to open surgery with earlier recovery and fewer complications in patients with high-occupancy TOLF.