Comparison of 3 Different Endoscopic Techniques for Lumbar Spinal Stenosis: Comprehensive Radiological and Clinical...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• Lumbar spinal stenosis (LSS) is a common condition causing neurogenic claudication.
• Endoscopic decompression techniques offer minimally invasive treatment options for LSS.
• Comparing the efficacy of different endoscopic approaches is crucial for optimal patient outcomes.

Purpose of the Study:

• To compare the clinical and radiological outcomes of three endoscopic decompression techniques for single-level lumbar spinal stenosis: unilateral biportal endoscopic lumbar decompression (UBELD), microendoscopic laminotomy (MEL), and percutaneous endoscopic lumbar decompression (PELD).

Main Methods:

• A multicenter retrospective study included patients with single-level lumbar spinal stenosis without instability.
• Clinical outcomes were assessed using Visual Analogue Scale (VAS) for extremity and back pain, and Japanese Orthopaedic Association (JOA) scores.
• Radiological outcomes were evaluated by measuring bilateral superior articular distance (SAD), lateral recess height (LR height), lateral recess angle (LR angle), and cross-sectional spinal canal area.

Main Results:

• All three techniques demonstrated statistically significant improvements in VAS and JOA scores postoperatively.
• At 12 months, MEL showed the highest lateral decompression values on the approach side, followed by UBELD and PELD.
• For contralateral decompression, the order of efficacy was UBELD > MEL > PELD.

Conclusions:

• All evaluated endoscopic techniques are effective for lumbar spinal stenosis decompression.
• UBELD and MEL provide superior lateral recess decompression compared to PELD.
• The choice of technique may influence the extent of lateral decompression achieved.