EC Orthopaedics

Background: Prior studies have shown that the source of axial back pain or radicular pain can be attributed to intervertebral disc, spinal stenosis, synovial cyst, or bone spurs. These pathologies have been treated surgically for decades with decompression via wide open laminectomy, discectomy or even with fusion procedures when indicated. Unilateral biportal endoscopic (UBE) decompression is a minimally invasive technique for treating such pathologies facilitating decompression while preserving spinal stability. The current study aims to find clinical outcomes of UBE decompression for degenerative lumbar canal stenosis (DLCS) amongst Australian population.

Methods: This is a single centre single surgeon retrospective study and includes patients who underwent UBE for DLCS from November 2022 to April 2023 with a minimum of six months of follow up. Patient’s demographic data, peri and post-operative data, and length of stay (LOS) were reviewed. Clinical outcomes was assessed using visual analog scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) pre-operatively and at 1, 3 and 6 months and the modified Macnab criteria at final follow up. A repeated ANOVA test was performed to measure the difference between VAS and ODI scores. P-value < 0.05 was considered statistically significant.

Results: The cohort consisted of 32 patients (M:18, F:14) with a mean age of 65.3 ± 12.3. The mean follow up period was 7.9 ± 0.9 months. The average length of hospital stay was 1.5 ± 0.5 days. At the final follow up, the mean VAS for back pain improved from 4.4 ± 0.8 to 2.9 ± 0.2 and the mean VAS for leg pain improved from 7.3 ± 1.1 to 0.3 ± 0.2. ODI scored significantly improved from 25.4 ± 4.3 to 4.8 ± 0.8. The modified Macnab criteria reported excellent in 23 patients (71.87%), good in 9 patients (28.13%). There were 2 dural tears which were managed with dura patch intraoperatively with no further sequelae.

Conclusion: Lumbar spinal decompression with UBE is a safe, predictable technique that achieves excellent results as evident clinically by improvement in VAS and ODI scores, reduced hospital LOS and early return to routine activities.

 Keywords: Lumbar Canal Stenosis; UBE; Endoscopy; Disc Prolapsed; Minimally Invasive Surgery

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