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REVIEW article
Front. Surg.
Sec. Orthopedic Surgery
Volume 11 - 2024 |
doi: 10.3389/fsurg.2024.1449838
Clinical Efficacy of Unilateral Laminotomy for Bilateral Decompression (ULBD) in the Treatment of Adjacent Segment Disease after Lumbar Fusion
Provisionally accepted- 1 Zhejiang Provincial People's Hospital, Hangzhou, China
- 2 Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui Province, China
Objective: To assess the clinical impact of unilateral laminotomy for bilateral decompression (ULBD) in managing patients with adjacent vertebrae following lumbar fusion.A retrospective analysis was conducted on 21 patients, with a mean age of 67.4 years, who underwent ULBD for adjacent vertebra disease at our department from January 2021 to November 2023. We reviewed demographic data, surgical techniques, imaging studies, and patient-reported outcomes. The study compared Visual Analog Scale (VAS) scores, Numeric Rating Scale (NRS) scores, Japanese Orthopaedic Association (JOA) scores, Short Form-36 (SF-36) scores, and imaging outcomes before surgery, immediately post-surgery, and at 1 month, 6 months, and 12 months post-surgery.Results: Evaluation of 21 patients with adjacent segment disease (ASD) (13 males, 8 females; mean age 67.42 years) was performed with follow-ups at various intervals post-surgery. Postoperative VAS, NRS, JOA, and SF-36 scores showed significant improvements compared to preoperative scores. Immediately after surgery, there were significant improvements in NRS score (2.76 ± 0.70 vs. 3.71 ± 0.85, P < 0.05) and JOA score (15.38 ± 1.02 vs. 9.29 ± 1.01, P < 0.05) compared to preoperative scores. Similarly, at 12 months post-surgery, significant improvements were observed in NRS score (1.52 ± 0.51 vs. 3.71 ± 0.85, P < 0.05) and JOA score (25.0 ± 1.10 vs. 9.29 ± 1.01, P < 0.05) compared to preoperative scores. The clinical satisfaction rate was 95.0% among all patients, with postoperative imaging examinations revealing a significant decompression effect. No complications were reported among the surgical patients.This study suggests that endoscopic ULBD can be a safe and effective technique for managing symptomatic ASD, providing satisfactory clinical outcomes for patients with ASD. Endoscopic ULBD may serve as an alternative treatment option for ASD with lumbar stenosis.
Keywords: unilateral laminotomy for bilateral decompression (ULBD), Lumbar stenosis, Adjacent segment disease, laminotomy, Decompression
Received: 16 Jun 2024; Accepted: 03 Sep 2024.
Copyright: © 2024 Xu, Liu, Ding, Ru, Wan, Ji, Liu, Guo, Hu, Zhang, Xu, Li and Cai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yun Xu, Zhejiang Provincial People's Hospital, Hangzhou, China
Yang Liu, Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230061, Anhui Province, China
Din Ding, Zhejiang Provincial People's Hospital, Hangzhou, China
Bin Ru, Zhejiang Provincial People's Hospital, Hangzhou, China
Quan Wan, Zhejiang Provincial People's Hospital, Hangzhou, China
Wenlong Liu, Zhejiang Provincial People's Hospital, Hangzhou, China
Ran Guo, Zhejiang Provincial People's Hospital, Hangzhou, China
Jiaqi Hu, Zhejiang Provincial People's Hospital, Hangzhou, China
Shun Li, Zhejiang Provincial People's Hospital, Hangzhou, China
Wenjun Cai, Zhejiang Provincial People's Hospital, Hangzhou, China
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Yun Xu
1*