• World Neurosurg · Apr 2021

    Comparative Study

    Clinical comparison of unilateral biportal endoscopic laminotomy versus microendoscopic laminotomy for single-level laminotomy: a single-center, retrospective analysis.

    • Zenya Ito, Motohide Shibayama, Shu Nakamura, Minoru Yamada, Masaki Kawai, Mikinobu Takeuchi, Hiroki Yoshimatsu, Keita Kuraishi, Naoto Hoshi, Yasushi Miura, and Fujio Ito.
    • Department of Orthopedic Surgery, Aichi Spine Hospital, Aichi, Japan. Electronic address: z.ito@nifty.com.
    • World Neurosurg. 2021 Apr 1; 148: e581-e588.

    BackgroundThe purpose of this study was to compare clinical results of microendoscopic laminectomy (MEL) with those of unilateral biportal endoscopic laminectomy (UBEL) in patients with single-level lumbar spinal canal stenosis.MethodsThe subjects consisted of 181 patients who underwent MEL (139 cases) and UBEL (42 cases) who were followed up for at least 6 months. All patients had lumber canal stenosis for 1 level. Outcomes of the patients were assessed with the duration of surgery, the bone resection area in 3-dimensional computed tomography, the facet preservation rates in computed tomography axial imagery, Visual Analog Scale (VAS) for low back pain, the Oswestry Disability Index, and the EuroQol 5-Dimensions questionnaire.ResultsThe bone resection area in 3-dimensional computed tomography was 1.5 for MEL versus 1.0 cm2 for UBEL (P < 0.05). The facet preservation rates on the advancing side and the opposite side were 78% versus 86% (advancing side: MEL vs. UBEL) and 85% versus 94% (opposite side) (P < 0.05). The VAS (low back pain) score, VAS (leg pain), Oswestry Disability Index, and EuroQol 5-Dimension questionnaire significantly dropped in both groups at the final period (P < 0.05), however, exhibiting no difference between the 2 groups at each period. MEL resulted in greater numbers of complications, including 5 cases of hematoma paralysis, 8 cases of dura injury, 2 cases of reoperation, as opposed to zero cases of hematoma paralysis and only 2 cases of dura injury resulting from UBEL.ConclusionsThe UBEL method is a more useful technique than the MEL method as it requires a smaller bone resection area and produces fewer complications.Copyright © 2021. Published by Elsevier Inc.

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