Clinical Outcomes of Uniportal and Biportal Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression in Patients with Lumbar Spinal Stenosis: A Retrospective Pair-Matched Case-Control Study.

Abstract

To compare the clinical outcomes of uniportal and biportal lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) in patients with lumbar spinal stenosis. A retrospective pair-matched case-control analysis of 72 patients with lumbar spinal stenosis was performed. According to the surgical procedure used, the patients were classified into 2 groups: 1) uniportal LE-ULBD and 2) biportal LE-ULBD. Clinical outcomes were assessed using the visual analog scale score, Oswestry Disability Index score, and Macnab criteria, and the results were compared between the groups. All patients were successfully treated with either uniportal or biportal LE-ULBD. The surgical duration in the biportal LE-ULBD group was significantly shorter than in the uniportal LE-ULBD group (P < 0.001). The time to ambulation and the length of hospitalization in the 2 groups were not significantly different. The visual analog scale and Oswestry Disability Index scores improved significantly after surgery in both groups (P < 0.001). Based on the Macnab criteria, 33 (91.7%) patients in the uniportal LE-ULBD group and 34 (94.4%) patients in the biportal LE-ULBD group were rated as having an excellent or good outcome. Additionally, intraoperative epineurium injury was observed in both the LE-ULBD groups. Both uniportal and biportal LE-ULBD procedures are safe and effective for treating patients with lumbar spinal stenosis. It is more feasible to decompress the spinal canal during biportal LE-ULBD than during uniportal LE-ULBD.