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,John O Ogunlade
{"title":"腰椎内窥镜单侧椎板切除术用于退行性脊椎滑脱症的双侧减压。","authors":"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,John O Ogunlade","doi":"10.1016/j.wneu.2024.09.017","DOIUrl":null,"url":null,"abstract":"INTRODUCTION\r\nDegenerative spondylolisthesis is an important cause of chronic low-back and radiculopathy in the adult US population. Open 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 FESS 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.\r\n\r\nMETHODS\r\nPatients with low-grade degenerative spondylolisthesis who underwent a lumbar endoscopic ULBD at six 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.\r\n\r\nRESULTS\r\nThis study included 73 patients from six spine centers. Sixty-two patients were diagnosed with grade 1 spondylolisthesis while 11 were diagnosed with grade 2 spondylolisthesis. Postoperatively 70 patients reported improved symptoms and pain resolution while three patients reported worse pain. Mean VAS back, VAS leg, and ODI scores showed a statistically significant improvement at 3, 9, and 12-months when compared to the preoperative period. Radiographically, no patient in our study had progression of grade of spondylolisthesis.\r\n\r\nCONCLUSION\r\nPatients with low-grade degenerative spondylolisthesis causing severe stenosis can safely be treated with lumbar endoscopic unilateral laminectomy for bilateral decompression. Head-to-head trial should be undertaken to provide higher level of clinical evidence.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lumbar Endoscopic Unilateral Laminectomy for Bilateral Decompression in Degenerative Spondylolisthesis.\",\"authors\":\"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,John O Ogunlade\",\"doi\":\"10.1016/j.wneu.2024.09.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"INTRODUCTION\\r\\nDegenerative spondylolisthesis is an important cause of chronic low-back and radiculopathy in the adult US population. Open 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 FESS 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.\\r\\n\\r\\nMETHODS\\r\\nPatients with low-grade degenerative spondylolisthesis who underwent a lumbar endoscopic ULBD at six 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. 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Lumbar Endoscopic Unilateral Laminectomy for Bilateral Decompression in Degenerative Spondylolisthesis.
INTRODUCTION
Degenerative spondylolisthesis is an important cause of chronic low-back and radiculopathy in the adult US population. Open 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 FESS 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.
METHODS
Patients with low-grade degenerative spondylolisthesis who underwent a lumbar endoscopic ULBD at six 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.
RESULTS
This study included 73 patients from six spine centers. Sixty-two patients were diagnosed with grade 1 spondylolisthesis while 11 were diagnosed with grade 2 spondylolisthesis. Postoperatively 70 patients reported improved symptoms and pain resolution while three patients reported worse pain. Mean VAS back, VAS leg, and ODI scores showed a statistically significant improvement at 3, 9, and 12-months when compared to the preoperative period. Radiographically, no patient in our study had progression of grade of spondylolisthesis.
CONCLUSION
Patients with low-grade degenerative spondylolisthesis causing severe stenosis can safely be treated with lumbar endoscopic unilateral laminectomy for bilateral decompression. Head-to-head trial should be undertaken to provide higher level of clinical evidence.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS