Unilateral microscopic approach for lumbar spinal stenosis decompression: a scoping review

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Microscopic unilateral laminotomy for bilateral decompression (ULBD) is a minimally invasive technique for lumbar spinal stenosis.
• Debate exists regarding ULBD's efficacy compared to conventional laminectomy (CL).

Purpose of the Study:

• To collate and describe the evidence for ULBD, focusing on perioperative parameters, functional outcomes, and complications.
• To identify operative techniques associated with ULBD.

Main Methods:

• A scoping review was conducted following PRISMA-ScR guidelines.
• Searched major databases for English articles (1990-2022) on ULBD for lumbar spinal stenosis.

Main Results:

• Seventeen articles met inclusion criteria; two were RCTs, two prospective, and the rest retrospective.
• Three studies compared ULBD with CL, suggesting ULBD preserves spinal structures, potentially reducing operative time and blood loss with similar outcomes.

Conclusions:

• ULBD minimizes disruption to spinal anatomy and shows acceptable clinical outcomes.
• Limited data from retrospective studies hinders definitive conclusions on ULBD's utility.