Editorial Type:
Article Category: Review Article
 | 
Online Publication Date: 20 Mar 2025

Early use of endoscopic unilateral laminectomy combined with bilateral decompressionin patients with adjacent segment disease after lumbar fusion

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DOI: 10.9738/INTSURG-D-25-00014.1
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Abstract

Objectives:

The purpose of this study was to investigate the safety and clinical effectiveness of endoscopic unilateral laminectomy with bilateral decompression (END-ULBD) in patients with adjacent segment disease (ASD) after lumbar fusion.

Methods:

We conducted a retrospective study and collected data on 9 patients with adjacent segment disease (ASD) after lumbar fusion who were hospitalized in our hospital from January 2021 to January 2022. All 9 patients, aged 54 to 77 years, received Endo-ULBD treatment, with an average age of 59.2±3.6 years. The ASD segments are L2/3 segment 1, L3/4 segment 5, and L5/S1 segment 3. The operation time and blood loss were recorded intraoperatively. For analysis, the visual analog scale (VAS), Oswestry Disability Index (ODI), and modified MacNab Lower Extremity Pain Criteria score were recorded at the last follow-up visit.

Results:

The surgery was successful in 9 patients. There was no neurological injury or dural rupture resulting in cerebrospinal fluid leakage. The average operation time was (90.25±118.0) minutes, the average blood loss was (35.3±5.3) ml, and the average hospitalization time was (14.4±2.1) days. The results also showed that ODI and VAS scores decreased significantly 1 week after surgery. All indicators were statistically improved 1 month after surgery (p<0.05). There was no statistically significant difference in ODI and VAS scores 1 month and 3 months after surgery. At the final follow-up, according to the modified MacNab criteria, 7 cases had excellent curative effect and 2 cases had good curative effect.

Conclusions:

In clinical practice, we found that Endod-Ulbd can be combined with a single portal vein endoscopy for ASD patients with bilateral lower limb symptoms after lumbar fusion, providing a new option for patients.

Keywords: lumbar fusion surgery; adjacent segment disease; spinal endoscopy; unilateral laminotomy and bilateral decompression; lumbar spinal stenosis

Contributor Notes

Address for correspondence: Bin Zhang, Department of spine surgery, Changsha Hospital of Traditional Chinese Medicine (Changsha Eighth Hospital),Changsha, 410002 Hunan,China. E-mail:13787074631@163.com.

Conflict of interest The authors declare no conflicts of interest statement.

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