• Rida Mitha, Mark A Mahan, Rujvee P Patel, Jhair Alejandro Colan, Jannik Leyendecker, Mark M Zaki, Edward Samir Harake, Varun Kathawate, Osama Kashlan, Sanjay Konakondla, Meng Huang, Galal A Elsayed, Daniel M Hafez, Brenton Pennicooke, Nitin Agarwal, Christoff P Hofstetter, and John Ogunlade.
• Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri, USA; Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
• World Neurosurg. 2024 Sep 10.

BackgroundDegenerative spondylolisthesis is an important cause of chronic low back pain and radiculopathy in the adult U.S.PopulationOpen decompression with or without fusion is considered the standard for management, yet optimal treatment remains controversial. Full endoscopic spine surgery offers an alternative surgical approach with possible advantages. There is a paucity of data on the use of full endoscopic spinal surgery in degenerative spondylolisthesis. Therefore, we present the clinical and radiographic outcomes of 73 patients with low-grade degenerative spondylolisthesis with severe stenosis, who underwent lumbar endoscopic unilateral laminectomy for bilateral decompression.MethodsPatients with low-grade degenerative spondylolisthesis who underwent a lumbar endoscopic ULBD at 6 spine centers in North America were included in this study. Patients were followed up at 3, 9, and 12 months. Static and dynamic imaging was performed and evaluated routinely before surgery to identify the pathology and grade of spondylolisthesis. Patient-reported outcomes were prospectively collected.ResultsThis study included 73 patients from 6 spine centers. Sixty-two patients were diagnosed with grade I spondylolisthesis, whereas 11 were diagnosed with grade II spondylolisthesis. Postoperatively, 70 patients reported improved symptoms and pain resolution, whereas 3 patients reported worse pain. Mean visual analog scale back and visual analog scale leg scores and Oswestry Disability Index showed a statistically significant improvement at 3, 9, and 12 months compared with the preoperative period. Radiographically, no patient in our study had progression of the grade of spondylolisthesis.ConclusionsPatients with low-grade degenerative spondylolisthesis causing severe stenosis can safely be treated with lumbar endoscopic unilateral laminectomy for bilateral decompression. A head-to-head trial should be undertaken to provide a higher level of clinical evidence.Copyright © 2024 Elsevier Inc. All rights reserved.

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