Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative Spondylolisthesis Using Unilateral Biportal Endoscopy
Objective This study aimed to evaluate the treatment of spinal stenosis with spondylolisthesis using bilateral-contralateral unilateral biportal endoscopic (UBE) decompression to minimize facet joint damage. Methods We retrospectively evaluated 42 patients with grade 1 spondylolisthesis who underwen...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2023-09-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://e-neurospine.org/upload/pdf/ns-2346504-252.pdf |
| _version_ | 1797330676599488512 |
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| author | Dong Hyun Lee Dong-Geun Lee Choon Keun Park Jae-Won Jang Jin Sub Hwang Jun Yong Kim Yong-Eun Cho Sang Won Lee Dong Chan Lee Bang Sang Han Sang Yeop Han |
| author_facet | Dong Hyun Lee Dong-Geun Lee Choon Keun Park Jae-Won Jang Jin Sub Hwang Jun Yong Kim Yong-Eun Cho Sang Won Lee Dong Chan Lee Bang Sang Han Sang Yeop Han |
| author_sort | Dong Hyun Lee |
| collection | DOAJ |
| description | Objective This study aimed to evaluate the treatment of spinal stenosis with spondylolisthesis using bilateral-contralateral unilateral biportal endoscopic (UBE) decompression to minimize facet joint damage. Methods We retrospectively evaluated 42 patients with grade 1 spondylolisthesis who underwent bilateral-contralateral UBE decompression between July 2018 and September 2019. To identify segmental instability, static and dynamic images from preoperative and postoperative procedures and final follow-up radiographs were reviewed. Lateral radiograph slippage ratio, sagittal motion, and facet joint preservation were evaluated. Clinical assessments were conducted using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria. Results The average final follow-up period was 26.5 ± 1.3 months. The average preoperative slip percentage was 15.70% ± 5.25%, which worsened to 18.80% ± 5.41% at the final follow-up (p < 0.005). The facet joint preservation rate was 95.6% ± 4.1% on the contralateral side. Improvements in the VAS scores (leg pain: from 7.9 ± 2.2 to 3.1 ± 0.7; p < 0.005; back pain: from 7.2 ± 3.0 to 2.8 ± 1.0; p < 0.005) were observed at the final follow-up. The mean preoperative ODI was 26.19 ± 3.42, which improved to 9.6 ± 1.0 (p < 0.005). Thirteen patients exhibited delayed focal segmental instability following decompression. Despite the absence of symptoms or improvement with conservative treatment in the majority of patients with delayed instability, two patients required fusion surgery to address the instability. Additionally, 2 patients developed facet synovial cysts, while 2 experienced spinous process fractures. Conclusion Bilateral decompression with a contralateral UBE approach could be an effective and alternative treatment method to reduce instability in spinal stenosis with grade 1 spondylolisthesis. |
| first_indexed | 2024-03-08T07:24:09Z |
| format | Article |
| id | doaj.art-47dcf715bd5c4401948338b5c41f743c |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T07:24:09Z |
| publishDate | 2023-09-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-47dcf715bd5c4401948338b5c41f743c2024-02-02T22:24:52ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912023-09-0120393193910.14245/ns.2346504.2521472Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative Spondylolisthesis Using Unilateral Biportal EndoscopyDong Hyun Lee0Dong-Geun Lee1Choon Keun Park2Jae-Won Jang3Jin Sub Hwang4Jun Yong Kim5Yong-Eun Cho6Sang Won Lee7Dong Chan Lee8Bang Sang Han9Sang Yeop Han10 Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Anyang, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, KoreaObjective This study aimed to evaluate the treatment of spinal stenosis with spondylolisthesis using bilateral-contralateral unilateral biportal endoscopic (UBE) decompression to minimize facet joint damage. Methods We retrospectively evaluated 42 patients with grade 1 spondylolisthesis who underwent bilateral-contralateral UBE decompression between July 2018 and September 2019. To identify segmental instability, static and dynamic images from preoperative and postoperative procedures and final follow-up radiographs were reviewed. Lateral radiograph slippage ratio, sagittal motion, and facet joint preservation were evaluated. Clinical assessments were conducted using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria. Results The average final follow-up period was 26.5 ± 1.3 months. The average preoperative slip percentage was 15.70% ± 5.25%, which worsened to 18.80% ± 5.41% at the final follow-up (p < 0.005). The facet joint preservation rate was 95.6% ± 4.1% on the contralateral side. Improvements in the VAS scores (leg pain: from 7.9 ± 2.2 to 3.1 ± 0.7; p < 0.005; back pain: from 7.2 ± 3.0 to 2.8 ± 1.0; p < 0.005) were observed at the final follow-up. The mean preoperative ODI was 26.19 ± 3.42, which improved to 9.6 ± 1.0 (p < 0.005). Thirteen patients exhibited delayed focal segmental instability following decompression. Despite the absence of symptoms or improvement with conservative treatment in the majority of patients with delayed instability, two patients required fusion surgery to address the instability. Additionally, 2 patients developed facet synovial cysts, while 2 experienced spinous process fractures. Conclusion Bilateral decompression with a contralateral UBE approach could be an effective and alternative treatment method to reduce instability in spinal stenosis with grade 1 spondylolisthesis.http://e-neurospine.org/upload/pdf/ns-2346504-252.pdfubecontralateralzygapophyseal jointspinal stenosisspondylolisthesis |
| spellingShingle | Dong Hyun Lee Dong-Geun Lee Choon Keun Park Jae-Won Jang Jin Sub Hwang Jun Yong Kim Yong-Eun Cho Sang Won Lee Dong Chan Lee Bang Sang Han Sang Yeop Han Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative Spondylolisthesis Using Unilateral Biportal Endoscopy Neurospine ube contralateral zygapophyseal joint spinal stenosis spondylolisthesis |
| title | Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative Spondylolisthesis Using Unilateral Biportal Endoscopy |
| title_full | Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative Spondylolisthesis Using Unilateral Biportal Endoscopy |
| title_fullStr | Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative Spondylolisthesis Using Unilateral Biportal Endoscopy |
| title_full_unstemmed | Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative Spondylolisthesis Using Unilateral Biportal Endoscopy |
| title_short | Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative Spondylolisthesis Using Unilateral Biportal Endoscopy |
| title_sort | saving stabilizing structure treatment with bilateral contralateral decompression for spinal stenosis in degenerative spondylolisthesis using unilateral biportal endoscopy |
| topic | ube contralateral zygapophyseal joint spinal stenosis spondylolisthesis |
| url | http://e-neurospine.org/upload/pdf/ns-2346504-252.pdf |
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