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. 2023 Jan 29;12(3):1033.
doi: 10.3390/jcm12031033.

A Comparative Analysis of Bi-Portal Endoscopic Spine Surgery and Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Stenosis Patients

Dong-Chan Eun  1 , Yong-Ho Lee  1 , Jin-Oh Park  1 , Kyung-Soo Suk  1 , Hak-Sun Kim  1 , Seong-Hwan Moon  1 , Si-Young Park  1 , Byung-Ho Lee  1 , Sang-Jun Park  1 , Ji-Won Kwon  1 , Sub-Ri Park  1
Affiliations

A Comparative Analysis of Bi-Portal Endoscopic Spine Surgery and Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Stenosis Patients

Dong-Chan Eun et al. J Clin Med. .

Abstract

The clinical and radiological results before and after surgery were compared and analyzed for patients with multilevel lumbar stenosis who underwent bi-portal endoscopic spine surgery (BESS) and microscopic unilateral laminotomy for bilateral decompression (ULBD). We retrospectively identified 47 and 49 patients who underwent BESS and microscopic ULBD, respectively, who were diagnosed with multi-level lumbar stenosis. Clinical outcomes were evaluated using the visual analog scale score for both back and leg pain, and medication (pregabalin) use and Oswestry Disability Index (ODI) scores for overall treatment outcomes were used pre-operatively and at the final follow-up. Radiological outcomes were evaluated as the percentage of dura expansion volume, and percentage preservation of both facets and both lateral recess angles. The follow-up period of patients was about 17.04 months in the BESS group and about 16.90 months in the microscopic ULBD group. The back and leg visual analog scale (VAS) scores and average pregabalin use decreased more significantly in the BESS group than in the microscopic ULBD group (each p-value 0.0443, <0.001, 0.0378). All radiological outcomes were significantly higher in the BESS group than in the ULBD group. The change in ODI in two-level spinal stenosis showed a significantly higher value in the BESS group compared to the microscopic ULBD group (p-value 0.0335). Multilevel decompression with the BESS technique in multiple spinal stenosis is an adequate technique as it shows better clinical and radiological results than microscopic ULBD during a short-term follow-up period.

Keywords: BESS; MIS; ULBD; lumbar; multilevel spinal stenosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pre-operative (a) and post-operative (b) MR images of a 76-year-old female patient with L3–4–5 spinal stenosis who underwent BESS surgery.
Figure 2
Figure 2
Pre-operative (a) and post-operative (b) MR images of a 72-year-old female patient with L3–4–5 spinal stenosis who underwent microscopic ULBD surgery.
Figure 3
Figure 3
Clinical outcomes: VAS score and medication use by range of levels. Back (a); leg (b); medication (mg) (c).
See this image and copyright information in PMC

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