Clinical Results and Review of Techniques of Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression (TE-ULBD) Using the Outside-In Technique for Thoracic Ossified Ligamentum Flavum
Objective Uniportal full endoscopic thoracic endoscopic surgery can be performed through transforaminal and interlaminar approaches. The interlaminar approach is commonly described as thoracic endoscopic unilateral laminotomy for bilateral decompression (TE-ULBD), which is typically indicated for pa...
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| Format: | Article |
| Language: | English |
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Korean Minimally Invasive Spine Surgery Society
2023-04-01
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| Series: | Journal of Minimally Invasive Spine Surgery and Technique |
| Subjects: | |
| Online Access: | http://www.jmisst.org/upload/pdf/jmisst-2023-00633.pdf |
| _version_ | 1797822007450009600 |
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| author | Hyeun Sung Kim Pang Hung Wu Il-Tae Jang |
| author_facet | Hyeun Sung Kim Pang Hung Wu Il-Tae Jang |
| author_sort | Hyeun Sung Kim |
| collection | DOAJ |
| description | Objective Uniportal full endoscopic thoracic endoscopic surgery can be performed through transforaminal and interlaminar approaches. The interlaminar approach is commonly described as thoracic endoscopic unilateral laminotomy for bilateral decompression (TE-ULBD), which is typically indicated for pathologies such as ossified ligamentum flavum and other posteriorly based compressive pathologies. TE-ULBD decompresses the central and lateral recesses of the thoracic spinal canal. Both the outside-in (over the top of ligamentum flavum) and inside-out (under the ligamentum flavum) approaches can decompress the thoracic spinal canal through the uniportal interlaminar endoscopic route. Methods A retrospective clinical cohort evaluation of patients who underwent TE-ULBD was performed from January 2018 to December 2021 Results A cohort of 50 cases of TE-ULBD with a mean age of 65 years old were evaluated. The complication rate was 5.4% and the reoperation rate was 2%. Statistically significant mean VAS improvements were found at 1 week, 6 months, and the final follow-up, with changes of 3.95±1.49, 4.95±1.7, and 5.2±1.8 points, respectively. Likewise, the mean Oswestry Disability Index improvements at 1 week, 3 months, and the final follow-up were 33.8±9.05, 40.12±10.38, and 41.92±11.26, respectively (p<0.001). Significant improvements were found in the cross-sectional area of the spinal canal in the upper endplate, mid-disc, and lower endplate (57.62±50.6, 89.86±55.93, and 64.93±60.91 mm2, respectively; p<0.001). Conclusion TE-ULBD using the outside-in technique could achieve good clinical outcomes and a low rate of complications in our cohort of patients. |
| first_indexed | 2024-03-13T10:02:23Z |
| format | Article |
| id | doaj.art-a5bc0b6c22b54ca8b8f1fcebc1c48fd9 |
| institution | Directory Open Access Journal |
| issn | 2508-2043 |
| language | English |
| last_indexed | 2024-03-13T10:02:23Z |
| publishDate | 2023-04-01 |
| publisher | Korean Minimally Invasive Spine Surgery Society |
| record_format | Article |
| series | Journal of Minimally Invasive Spine Surgery and Technique |
| spelling | doaj.art-a5bc0b6c22b54ca8b8f1fcebc1c48fd92023-05-23T05:01:32ZengKorean Minimally Invasive Spine Surgery SocietyJournal of Minimally Invasive Spine Surgery and Technique2508-20432023-04-0181748110.21182/jmisst.2023.00633168Clinical Results and Review of Techniques of Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression (TE-ULBD) Using the Outside-In Technique for Thoracic Ossified Ligamentum FlavumHyeun Sung Kim0Pang Hung Wu1Il-Tae Jang2 Nanoori Hospital Gangnam, Seoul, Korea Nanoori Hospital Gangnam, Seoul, Korea Nanoori Hospital Gangnam, Seoul, KoreaObjective Uniportal full endoscopic thoracic endoscopic surgery can be performed through transforaminal and interlaminar approaches. The interlaminar approach is commonly described as thoracic endoscopic unilateral laminotomy for bilateral decompression (TE-ULBD), which is typically indicated for pathologies such as ossified ligamentum flavum and other posteriorly based compressive pathologies. TE-ULBD decompresses the central and lateral recesses of the thoracic spinal canal. Both the outside-in (over the top of ligamentum flavum) and inside-out (under the ligamentum flavum) approaches can decompress the thoracic spinal canal through the uniportal interlaminar endoscopic route. Methods A retrospective clinical cohort evaluation of patients who underwent TE-ULBD was performed from January 2018 to December 2021 Results A cohort of 50 cases of TE-ULBD with a mean age of 65 years old were evaluated. The complication rate was 5.4% and the reoperation rate was 2%. Statistically significant mean VAS improvements were found at 1 week, 6 months, and the final follow-up, with changes of 3.95±1.49, 4.95±1.7, and 5.2±1.8 points, respectively. Likewise, the mean Oswestry Disability Index improvements at 1 week, 3 months, and the final follow-up were 33.8±9.05, 40.12±10.38, and 41.92±11.26, respectively (p<0.001). Significant improvements were found in the cross-sectional area of the spinal canal in the upper endplate, mid-disc, and lower endplate (57.62±50.6, 89.86±55.93, and 64.93±60.91 mm2, respectively; p<0.001). Conclusion TE-ULBD using the outside-in technique could achieve good clinical outcomes and a low rate of complications in our cohort of patients.http://www.jmisst.org/upload/pdf/jmisst-2023-00633.pdfspinal stenosisendoscopic spine surgeryminimally invasive spine surgerythoracic spineligamentum flavumomit foraminal ligament |
| spellingShingle | Hyeun Sung Kim Pang Hung Wu Il-Tae Jang Clinical Results and Review of Techniques of Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression (TE-ULBD) Using the Outside-In Technique for Thoracic Ossified Ligamentum Flavum Journal of Minimally Invasive Spine Surgery and Technique spinal stenosis endoscopic spine surgery minimally invasive spine surgery thoracic spine ligamentum flavum omit foraminal ligament |
| title | Clinical Results and Review of Techniques of Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression (TE-ULBD) Using the Outside-In Technique for Thoracic Ossified Ligamentum Flavum |
| title_full | Clinical Results and Review of Techniques of Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression (TE-ULBD) Using the Outside-In Technique for Thoracic Ossified Ligamentum Flavum |
| title_fullStr | Clinical Results and Review of Techniques of Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression (TE-ULBD) Using the Outside-In Technique for Thoracic Ossified Ligamentum Flavum |
| title_full_unstemmed | Clinical Results and Review of Techniques of Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression (TE-ULBD) Using the Outside-In Technique for Thoracic Ossified Ligamentum Flavum |
| title_short | Clinical Results and Review of Techniques of Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression (TE-ULBD) Using the Outside-In Technique for Thoracic Ossified Ligamentum Flavum |
| title_sort | clinical results and review of techniques of thoracic endoscopic unilateral laminotomy with bilateral decompression te ulbd using the outside in technique for thoracic ossified ligamentum flavum |
| topic | spinal stenosis endoscopic spine surgery minimally invasive spine surgery thoracic spine ligamentum flavum omit foraminal ligament |
| url | http://www.jmisst.org/upload/pdf/jmisst-2023-00633.pdf |
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