Abstract:
Objective To compare the short-term clinical efficacy of uni-channel and dual-channel endoscopic lateral recess decompression on short-term efficacy for lumbar lateral recess stenosis.
Methods The clinical data fifty-one patients with lumbar lateral recess stenosis were retrospectively analyzed. According to different surgical methods, they were divided into percutaneous endoscopic lumbar discectomy (PELD) group (n=29) and unilateral biportal endoscopic (UBE) group (n=22). The operation time, fluoroscopy times, postoperative bedridden time, Visual Analogue Scale (VAS) of lumbar and legs of different time points and Oswestry disability index (ODI) were compared between the two groups; modified MacNab standard was used to evaluate the efficacy of the two groups.
Results The incision length in the PELD group was significantly shorter, and the number of intraoperative fluoroscopy in the PELD group was significantly more than that in the UBE group (P < 0.05); there were no significant differences in operation time and postoperative bed rest time between the two groups (P>0.05). On the third postoperative day, the VAS score of low back pain in the PELD group was significantly lower than that in the UBE group (P < 0.05). There was no significant difference in VAS score of low back pain between the two groups before operation, 3 months after operation and at the last follow-up (P>0.05); there were no significant differences in VAS score and ODI of leg pain between the two groups before operation, 3 days, 3 months after operation and at the last follow-up (P>0.05). At last follow-up, the excellent and good rate of modified MacNab standard was 89.7% (26/29) in the PELD group and 90.9% (20/22) in the UBE group, and the difference was not statistically significant (P>0.05).
Conclusion Both PELD and UBE techniques have good short-term efficacy in the treatment of lumbar lateral crypt stenosis. PELD is more minimally invasive than UBE, only requiring local anesthesia and better decompression of ventral nerve roots, while UBE is more flexible and more thorough for decompression of dorsal nerve roots.