International Journal of Spine Surgery最新文献

{"title":"Does Anterior Lumbar Interbody Fusion Reduce Mechanical Complication and Pseudarthrosis Rate at the Lumbosacral Junction in Adult Spinal Deformity Surgery in Comparison to Posterior Lumbar Interbody Fusion?","authors":"Mohamed Kamal A Mohamed, Michael Rauschmann, Andrei Slavici, Marcus Rickert, Sebastian Walter, Nikolaus Kernich, Krishnan Sircar, Peer Eysel, Vincent J Heck","doi":"10.14444/8774","DOIUrl":"https://doi.org/10.14444/8774","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the impact of anterior lumbar interbody fusion (ALIF) vs posterior lumbar interbody fusion (PLIF) at the lumbosacral junction on mechanical complications and fusion rate at the caudal lumbar segments in adult spinal deformity (ASD) surgery.</p><p><strong>Methods: </strong>This retrospective cohort study included ASD patients with coronal or sagittal imbalance who underwent thoracolumbar to pelvic fusion with ALIF or PLIF technique at the lumbosacral junction and a minimum follow-up of 2 years. The primary focus was on mechanical complications, including material failure and sacral fracture, implant-related pain, pseudarthrosis, and reoperation. Patient-specific and perioperative characteristics were also analyzed at the 2-year follow-up. The primary focus was on mechanical complications, including material failure and sacral fracture, implant-related pain, pseudarthrosis, and reoperation. Patient-specific and perioperative characteristics were also analyzed.</p><p><strong>Results: </strong>A total of 56 patients were included, comprising 32 ALIF and 24 PLIF patients, with a mean age of 79.5 ± 6.6 years. The overall mechanical complication rate was 19.6%, including screw loosening (7.1%), rod breakage (5.4%), sacral fracture (3.6%), and screw breakage (1.8%). Pseudarthrosis and reoperation rates were 10.7% each. ALIF significantly reduced mechanical complications compared with PLIF (9.4% vs 37.5%, <i>P</i> = 0.011). The ALIF group also showed lower rates of pseudarthrosis, implant-related pain, and reoperation (<i>P</i> < 0.05). Regression analysis identified PLIF as an independent risk factor for mechanical complications (<i>P</i> = 0.006). Length of hospital stay, operative time, and pseudarthrosis rate were significantly associated with an increased rate of mechanical complications, but patient demographics had no significant impact.</p><p><strong>Conclusion: </strong>Approximately 1 in 5 patients experiences mechanical complications within 2 years of ASD correction surgery. ALIF at the lumbosacral junction significantly reduces mechanical complications and pseudarthrosis compared with PLIF, resulting in lower reoperation rates. These findings suggest that ALIF should be the preferred technique for lumbosacral fusion in long-segment ASD constructs, provided there is no spondylolisthesis or severe spinal stenosis with L5 nerve root compression requiring simultaneous direct posterior decompression and fusion. This is particularly important in patients at risk for mechanical complications and pseudarthrosis, including those undergoing revision procedures.</p><p><strong>Level of evidence: </strong>3 - Retrospective comparative study.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The First Grade III Lumbar Spondylolisthesis Treated With the Novel 360° Artificial Disc/Artificial Facet Replacement Solution.","authors":"Jared D Ament, Jack Petros, Cooper Gardner, Amir Vokshoor","doi":"10.14444/8769","DOIUrl":"https://doi.org/10.14444/8769","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The incidence of spondylolisthesis increases with age and is more prevalent in women. \"High-grade\" (above grade II) occurs in 10% to 12% of affected individuals. Patients often present with back pain as well as leg pain, numbness, paresthesias, hamstring tightness, radiculopathy, and neurogenic claudication. If conservative therapy fails , the standard of care is fusion. However, despite its effectiveness in stabilizing the spine, fusion causes biomechanical load transfer to adjacent vertebrae, which can increase the risk of adjacent segment disease and reduce range of motion. These drawbacks are especially problematic for younger, more active patients who wish to maintain a high quality of life. In this report, we describe an innovative 360º, motion-preserving surgical approach utilizing 2 FDA-approved devices, the Prodisc L Artificial Disc Replacement and the Total Posterior Spine System, in an \"off-label\" investigational manner for the treatment of high-grade spondylolisthesis and associated disc space collapse.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This case report is part of a multi-institution, Institutional Review Board-approved, prospective cohort trial. Subjective and objective outcomes were collected every 6 to 12 weeks. Patient satisfaction scores as well as patient-reported outcomes included neurologic examination, visual analog scale (VAS) back pain, VAS left leg pain, VAS right leg pain, Patient-Reported Outcomes Measurement Information System (PROMIS), PROMIS physical health, PROMIS mental health, 12-item short form (SF-12), need for repeat surgery, patient's recommendations pertaining to their surgery, and postoperative radiographic dynamic x-ray images. A 36-year-old man presented to the clinic with complaints of progressive 7 to 8/10 low back pain with pain radiating down his legs bilaterally. The patient reported years of symptoms, only mildly managed with conservative therapy. He had been offered fusion by multiple surgeons. Imaging demonstrated progression of his known L5 to S1 grade II spondylolisthesis with severe disc space collapse to now grade III.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The patient's Oswestry Disability Index improved from 16 to 2 (87.5%) at 3 months postoperatively. The patient's VAS score for back, left, and right leg pain was 4.87, 2.41, and 1.51 preoperatively. All VAS scores decreased to 0 by 3 months. The PROMIS physical health score of 14 remained relatively stable at 13 at 3 months. The SF-12 physical and mental component scores improved by 16.7% and 21.23%, respectively. By 6 weeks postoperation, the patient expressed high satisfaction of 8 out of 10, improving to 10 out of 10 by 3 months. Results have been maintained at 9 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This case illustrates encouraging early data in support of a 360º arthroplasty concept in the treatment of high-grade spondylolisthesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;This cutting-edge motion preservati","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ISASS Recommendations and Coverage Criteria for Bone-Anchored Annular Defect Closure Following Lumbar Discectomy: Coverage Indications, Limitations, and/or Medical Necessity-An ISASS 2025 Policy Update on the Use of Bone-Anchored Annular Closure to Prevent Reherniation in High-Risk Lumbar Discectomy Patients.","authors":"Morgan P Lorio, Richard A Kube, John Ratliff, Anthony DiGiorgio, David A Essig, Kris Radcliff, Kai-Uwe Lewandrowski, Jon E Block","doi":"10.14444/8770","DOIUrl":"https://doi.org/10.14444/8770","url":null,"abstract":"<p><p>Patients with symptomatic lumbar disc herniation with radiculopathy where there is a large residual annular defect following discectomy are at greater risk of reherniation with symptom recurrence and revision surgery. These patients may benefit from primary annular repair. In 2019, the International Society for the Advancement of Spine Surgery published clinical guidelines supporting the use of bone-anchored annular closure in patients with large annular defects who are at greater risk for recurrent disc herniation. This 2025 update is provided to (1) summarize the current, increased clinical evidence for bone-anchored annular closure with greater follow-up durations and (2) update guidance for coding in light of new diagnostic and upcoming current procedural terminology codes. Based on accumulating clinical evidence, the International Society for the Advancement of Spine Surgery reiterates its position that in patients with symptomatic lumbar disc herniation with radiculopathy undergoing primary discectomy with large (≥6 mm wide) annular defects, bone-anchored annular closure may be used to sustain the treatment benefits of discectomy.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Perspectives on Awake Transforaminal Endoscopic Decompression Surgery Outcomes.","authors":"Albert E Telfeian, Rohaid Ali, Sanjay Konakondla, Kai-Uwe Lewandrowski","doi":"10.14444/8763","DOIUrl":"10.14444/8763","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate patient perceptions of the outcomes following awake transforaminal endoscopic lumbar decompression surgery for treating degenerative spine diseases.</p><p><strong>Methods: </strong>Over a 1-year period from 2022 to 2023, awake transforaminal endoscopic spine surgeries were performed on 183 patients using local anesthesia and sedation, allowing patients to communicate with the surgical team throughout the procedure. A follow-up app-based survey was sent to these patients to assess their perceptions and outcomes related to the surgery.</p><p><strong>Results: </strong>Out of 183 recipients, 102 patients completed the survey. At the 1-year follow-up, 89.2% of the respondents reported better outcomes in comparison to traditional spine surgeries, and 98% expressed willingness to recommend the procedure to others with similar conditions.</p><p><strong>Conclusions: </strong>The findings demonstrate notable advancements in minimally invasive spine surgery, with awake transforaminal endoscopic decompression showing high satisfaction rates tied closely to meeting patient expectations. The study also identifies areas for improvement, particularly in managing postoperative pain and aligning patients' expectations with clinical results.</p><p><strong>Clinical relevance: </strong>Effective preoperative communication and consistent pain management practices are critical in enhancing patient satisfaction and postoperative recovery, along with the integration of conservative treatments such as physical therapy and acupuncture to maximize surgical outcomes.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O-Arm Vs Surgivisio for Pedicle Screw Insertion: A Prospective Study on Screw Accuracy and Irradiation on 100 Patients.","authors":"Marc Prod'homme, Maxime Saad, Jérôme Tonetti, Guillaume Cavalié, Gaël Kerschbaumer, Arun Thangavelu, Jean-Loup Gassend, Mehdi Boudissa","doi":"10.14444/8766","DOIUrl":"https://doi.org/10.14444/8766","url":null,"abstract":"<p><strong>Background: </strong>Computerized navigation improves the accuracy of spine procedures. However, intraoperative imaging is plagued by ionizing irradiation and its cancer risk. Advanced technologies attempt to optimize the radiation dose. The goal of this study was to compare radiation exposure and screw accuracy of O-arm navigation and the Surgivisio device (SD) in pedicle screw insertion.</p><p><strong>Methods: </strong>All patients operated on by navigated pedicle screw insertion during a 19-month period were prospectively included in 2 spine centers: the first with the O-arm and the second with the SD. Demographic, operative, and irradiation data were collected. The accuracy of the screw positioning was assessed using the Heary and Gertzbein classifications. The effective dose in millisievert (mSv) was calculated.</p><p><strong>Results: </strong>One hundred patients were included, 50 per group. Five hundred and twelve screws were inserted, among them 228 in 120 vertebrae with the O-am and 284 in 145 vertebrae with the SD. Screw accuracy was 99.1% with the O-arm vs 93.3% with the SD (<i>P</i> = 0.07). Operative times were similar, with 145 vs 139 minutes respectively, <i>P</i> = 0.68. The effective dose was significantly higher in the O-arm group, with 5.43 vs 2.70 mSv with the SD (<i>P</i> < 0.01). The effective dose related to 2-dimensional imaging was significantly lower in the O-arm group than in the SD group, with 0.26 vs 1.16 mSv, respectively, <i>P</i> < 0.01, related to a shorter imaging duration (4 vs 109 seconds respectively, <i>P</i> < 0.01).</p><p><strong>Conclusions: </strong>Accuracy of pedicle screws was higher with the O-arm than with the Surgivisio, but the latter showed less radiation exposure. Despite promising results, improvements in technology should be pursued for ergonomics and surgical safety.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Lumbosacral-Pelvic Fixation Strategies.","authors":"Pawel P Jankowski, Sohaib Z Hashmi, Elizabeth L Lord, Joshua E Heller, David A Essig, Peter G Passias, Paritash Tahmasebpour, Robyn A Capobianco, Christopher J Kleck, David W Polly, Scott L Zuckerman","doi":"10.14444/8765","DOIUrl":"https://doi.org/10.14444/8765","url":null,"abstract":"<p><strong>Background: </strong>We sought to better understand the current decision-making criteria and surgical strategies for pelvic fixation in spinal surgery.</p><p><strong>Methods: </strong>A 28-question survey was distributed to an international group of practicing spine surgeons. Questions included training, practice type, criteria for using pelvic fixation, and strategies for pelvic fixation, including the type and technique employed.</p><p><strong>Results: </strong>Of the 56 responders, 32% were neurosurgeons, and 67% were affiliated with academic institutions. Factors that most influenced the use of pelvic fixation were 3-column osteotomy (3CO), high-grade spondylolisthesis, and L5 to S1 pseudarthrosis. Most report using a single point of pelvic fixation per side for the following: deformity 4+ levels without 3CO (55%) and spondylolisthesis grade 3 (59%). The upper instrumented vertebra threshold for pelvic fixation in degenerative pathology was L2 (70%) or L3 (16%). Most surgeons chose 2 points of fixation per side in the setting of 4 or more levels with 3CO (69%) and revision of at least 3 levels (68%). The predominant (77.6%) fixation preference was S2-alar-iliac screws. Surgeons report using navigation (70%), fluoroscopy (23%), free hand (21%), and robot-assisted (7%) for screw placement. The most common pelvic screw diameter and length were 8.5 mm and 90 mm, respectively. A 5% to 10% pelvic fixation revision rate was reported, primarily for instrumentation failure or pseudarthrosis.</p><p><strong>Conclusion: </strong>This survey-based study highlights factors influencing surgeons' decisions on pelvic instrumentation. While complex corrections or revisions often require robust fixation, variability arises in simpler cases, influenced by factors like age, obesity, and bone quality.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Postoperative Urinary Tract Infection in Patients Undergoing Arthrodesis for Spinal Deformity of Different Levels.","authors":"Hannah Shelby, Tara Shelby, Zoe Fresquez, Jeffrey C Wang, Raymond Hah","doi":"10.14444/8724","DOIUrl":"10.14444/8724","url":null,"abstract":"<p><strong>Background: </strong>While studies have identified urinary tract infection (UTI) as a complication after spine fusion, UTI is understudied in the context of fusion for spinal deformity. This study sought to determine both UTI incidence after multilevel posterior fusion for spinal deformity and whether pooled risk factors (RFs) increased UTI risk.</p><p><strong>Methods: </strong>Patients who had posterior fusion for spinal deformities between 2010 to 2019 were queried from the PearlDiver database, separated by the number of levels operated on (<7, 7-12, and >12), matched for age/gender, and analyzed for UTI incidence within 1 week and 1, 2, and 3 months. Any patient with a note of diabetes, obesity, rheumatoid arthritis, or coronary artery disease within 1-year prior to surgery and who contracted UTI within 1 month after fusion was included in the RF group for each level span. Patients of each level span with any RF were compared with those without any RFs. <i>χ</i> ² tests were used for statistical analyses.</p><p><strong>Results: </strong>A total of 20,893 patients underwent posterior fusion for spinal deformities from 2010 to 2019. After matching, each level set had 2239 patients. At 1, 2, and 3 months, the >12 levels subgroup showed statistically higher UTI incidence than the 7 to 12 and <7 levels subgroups. At 3 months, UTI was similar between the <7 and 7 to 12 subgroups, with 3.8% and 3.9%, respectively (<i>P</i> = 0.41), and UTI was statistically higher in the >12 subgroup at 4.6% (<7 vs 7-12: <i>P</i> = 0.005; <7 vs >12: <i>P</i> < 0.001). For each level group, the RF groups had significantly higher UTI rates at 1, 2, and 3 months. ORs were significantly greater than 1 for RF groups across all level subgroups (<7 OR = 2.8, <i>P</i> < 0.001; 7-12 OR = 2.1, <i>P</i> < 0.001; >12 OR = 2.3, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Diabetes, obesity, rheumatoid arthritis, and coronary artery disease were associated with a higher risk of UTI after posterior fusion for spinal deformity for all level sets. patients who underwent procedures for more than 12 levels had the highest rate of UTI. This is the first study to analyze and compare UTI incidence following fusion for spinal deformity.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"296-301"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spine Surgery Fellowships in Mexico: Web Content and Accessibility.","authors":"Felipe Aguilar-Chavez, Fernando Gonzalez-Gonzalez, Angel Lee, Orlando Alvarez-Medina, Adrian Anchondo-Alvidrez, Maria Elena Martinez Tapia, Carlos A Arellanes-Chavez","doi":"10.14444/8767","DOIUrl":"10.14444/8767","url":null,"abstract":"<p><strong>Background: </strong>The emergence of spine surgery fellowship programs in Mexico is gaining significance; however, there exists a paucity of available information pertaining to the specific requirements and criteria employed for candidate selection, operational structure, and educational framework, which affects the ability of potential applicants to make informed decisions about their training options.</p><p><strong>Methods: </strong>A systematic web search was executed to identify the official websites of the predominant private and public health care institutions that provide spine fellowship programs in Mexico. This search was carried out by 3 spine surgery fellows between December 2023 and January 2024 utilizing the Google search engine with specific keywords previously employed in similar studies. Subsequently, we performed an evaluation to ascertain the existence of 13 elements that are pertinent to residency candidates and the ease of finding information for each program.</p><p><strong>Results: </strong>Twenty-five spine surgery fellowship programs were identified. Of these, 14 (56%) are endorsed by the Autonomous University of Mexico, 2 (8%) by La Salle University, and the remainder by various universities such as the Autonomous University of Guadalajara and the Autonomous University of Chihuahua, among others. The majority of programs were listed on the website of the Mexican Association of Spine Surgeons, with contact information being readily available in most cases (72%), whereas details about program chairs were primarily found on hospital websites (16%). The simplicity of the search revealed that 88% of programs could be easily located online.</p><p><strong>Conclusions: </strong>Numerous spine surgery training programs are deficient in thorough online information, which creates challenges for prospective national and international applicants seeking details. Most programs depend on their reputation instead of an online presence, indicating a chance to improve marketing and visibility of spine surgery fellowship programs in Mexico.</p><p><strong>Clinical relevance: </strong>The training of spine surgeons is extremely important, so the visibility of training programs helps promote this specialty and, therefore, the training of surgeons.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"355-361"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Police Enforcement and Policy Impact on Moped-Related Spinal Injuries.","authors":"Niyousha Rahimimovaghar, Vafa Rahimi-Movaghar","doi":"10.14444/8750","DOIUrl":"10.14444/8750","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"353-354"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Clinical and Radiologic Evaluation of Endoscopic Unilateral Laminectomy for Bilateral Decompression in Degenerative Lumbar Spinal Stenosis: A Retrospective Study.","authors":"Chunliang Guo, Tao Ding, Jianqing Zheng, Xiule Fang, Zhiyun Feng, Yuntao Xue","doi":"10.14444/8725","DOIUrl":"10.14444/8725","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>This study aims to evaluate the changes in radiologic parameters and clinical outcomes associated with endoscopic ULBD for treating spinal stenosis.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i> < 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 (<i>P</i> < 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%.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"338-345"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}