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Saving Stabilizing Structure Treatment With Bilateral-Contralateral Decompression for Spinal Stenosis in Degenerative
Dong Hyun Lee1, Dong-Geun Lee1, Choon Keun Park1
1Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea.
Neurospine
|October 6, 2023
Summary
Bilateral-contralateral unilateral biportal endoscopic decompression effectively treats spinal stenosis with spondylolisthesis, preserving facet joints and improving pain and function. This minimally invasive approach offers a viable alternative for managing instability.
Area of Science:
- Minimally Invasive Spine Surgery
- Spinal Decompression Techniques
- Degenerative Spinal Conditions
Background:
- Spinal stenosis with spondylolisthesis presents a surgical challenge, often requiring decompression that can compromise facet joint integrity.
- Unilateral biportal endoscopic (UBE) surgery offers a minimally invasive alternative for spinal decompression.
Purpose of the Study:
- To evaluate the efficacy of bilateral-contralateral UBE decompression in treating spinal stenosis with grade 1 spondylolisthesis.
- To assess the impact of this technique on facet joint preservation and spinal stability.
- To analyze clinical outcomes including pain reduction and functional improvement.
Main Methods:
- Retrospective analysis of 42 patients with grade 1 spondylolisthesis treated with bilateral-contralateral UBE decompression.
- Evaluation of preoperative and postoperative radiographs to assess slippage, sagittal motion, and facet joint preservation.
- Clinical outcomes measured using Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI), and modified MacNab criteria.
Main Results:
- Significant improvement in leg and back pain (VAS) and Oswestry Disability Index (ODI) scores post-surgery.
- High facet joint preservation rate (95.6%) on the contralateral side.
- While 13 patients showed delayed segmental instability, most were managed conservatively; two required fusion. Minor complications included synovial cysts and spinous process fractures.
Conclusions:
- Bilateral-contralateral UBE decompression is an effective treatment for spinal stenosis with grade 1 spondylolisthesis.
- The technique demonstrates potential for reducing instability while preserving facet joints.
- It represents a valuable alternative surgical option for this patient population.
