Dataset Information

Unilateral Biportal Endoscopy Versus Tubular Microendoscopy in Management of Single Level Degenerative Lumbar Canal Stenosis: A Prospective Study.

ABSTRACT:

Study design

Prospective clinical study.

Summary of background data

To the authors knowledge, there are no previous prospective studies to test the feasibility of the unilateral biportal endoscopic (UBE) technique in management of lumbar canal stenosis.

Purpose

The study was conducted to compare clinical results of the UBE technique with the tubular microendoscopic (TME) surgery for management of degenerative lumbar canal stenosis.

Methods

One hundred fifty-four cases of single level degenerative lumbar canal stenosis were randomly divided into 2 groups. Each group consisted of 77 cases: one group underwent UBE and the other TME. Clinical outcome was assessed periodically: early postoperative, at 1, 3, and every 6 months for 2 years. Clinical outcome assessment operatives included the Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), and patient satisfaction using Modified Macnab Criteria (MMC). In addition, the admission period, operative time, and estimated blood loss were compared.

Results

In UBE cases, ODI and ZCQ were statistically superior to TME for all periods (P<0.05). For both approaches, values presented progressive improvement until the 24th month. Regarding ODI, UBE and TME had an 84% and 79% success rate, respectively. In ZCQ, UBE and TME had a 79% and 73% success rate, respectively, at the end of the 24th month. Regarding the MMC, UBE and TME had 63% and 29% excellent results, respectively. UBE also has shorter admission period (days: 1.11 vs. 1.28), operative time (minutes: 57.74 vs. 65.31), and less estimated blood loss (mL: 49.47 vs. 53.57).

Conclusions

Given its demanding learning curve, UBE is considered an effective alternative to TME with a higher clinical success rate.

SUBMITTER: Aygun H

PROVIDER: S-EPMC8225231 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundDegenerative lumbar spinal stenosis (LSS) is a prevalent condition in adults over the age of 55 years. The condition is associated with activity limitations that are related to increased pain when engaging in weight-bearing activities, such as walking and standing, and release of pain while sitting down or bending forward. The limitation on ambulation is also associated with impaired balance although the types of balance problems are sparsely described in this patient group. The purpose of this study was to assess dynamic balance in persons with LSS by the Mini-BESTest and explore the associations with self-reported balance and functional disability.MethodsSixty two participants were included in this cross-sectional study. The main outcome measure was the Mini-BESTest, providing a total score and sub-scores for 4 balance control systems (Anticipatory Adjustment, Reactive Response, Sensory Orientation, Stability of Gait). The Swiss Spinal Stenosis Questionnaire provided sub-scores for self-reported balance problems and walking function (FUNC).ResultsThe participants showed large inter-individual variation in all measures of balance. The Mini-BESTest score ranged from very good to poor and the mean value was 22.8 (SD 3.5). Nineteen participants (31%) reported having frequent balance problems. Logistic regression analyses showed that both the total Mini-BESTest score (OR (95% CI) 1.6 (1.2, 2.0)(P?=?.001) and 3 of the 4 balance control systems (Anticipatory Adjustment, Sensory Orientation, Stability in Gait) were significantly associated with self-reported balance problems (.001???P???.01). The strongest association was seen between Sensory Orientation and balance problems, implying that it is 4.4 times more likely that persons would have no or occasional balance problems with each unit of increase in Sensory Orientation. The total score for the Mini-BESTest was significantly associated with FUNC (P?=?.042).ConclusionsThe dynamic balance of persons with LSS showed a large heterogeneity with a large fraction of the participants displaying no balance impairments. The test results were associated with the participants' self-reported balance problems and walking function. The Mini-BESTest thus appears to provide additional information to self-reported disability, and by identifying different kind of balance control impairments, the Mini-BESTest could be useful for physiotherapists working with person-centered rehabilitation in persons with LSS.