Is the Use of a Unilateral Biportal Endoscopic Approach Associated with Rapid Recovery After Lumbar Decompressive Laminectomy? A Preliminary Analysis of a Prospective Randomized Controlled Trial

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Abstract

Objective: The purpose of this study was to assess the immediate postoperative clinical outcomes and perform a preliminary analysis of the effectiveness of biportal endoscopic approaches to lumbar decompressive laminectomy in the treatment of lumbar spinal stenosis. Methods: All participants (64 patients) were randomly assigned in a 1:1 ratio to either the biportal endoscopic lumbar decompressive laminectomy (BE-D) group or the mini–open microscopic lumbar decompressive laminectomy (MI-D) group. Early postoperative outcomes were evaluated using clinical and surgical technique–related outcomes. The visual analog scale (VAS) pain score was measured at 6 time points after surgery (at 4, 8, 16, 24, and 48 hours and 2 weeks). Surgical technique–related outcomes were also analyzed. Results: There were no significant differences in the preoperative demographics between the 2 groups. The VAS pain score from 8 to 48 hours (P < 0.05) was significantly lower in the BE-D group than in the MI-D group. Moreover, the total amount of fentanyl usage was higher in the MI-D group than in the BE-D group after surgery (P = 0.026). The length of hospital stay was lower in the BE-D group than in the MI-D group (P = 0.048). The operative time and creatinine phosphokinase level were not significantly different between the groups (P >0.05). Postoperative drainage was significantly higher in the BE-D group than in the MI-D group. Conclusions: BE-D was associated with rapid pain recovery, low fentanyl usage, and early discharge after surgery, but its other benefits have not yet been shown.

Original languageEnglish
Pages (from-to)e709-e718
JournalWorld Neurosurgery
Volume128
DOIs
StatePublished - 1 Aug 2019

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Laminectomy
Randomized Controlled Trials
Pain Measurement
Spinal Stenosis
Fentanyl
Drainage
Demography
Pain
Therapeutics

Keywords

  • Biportal endoscopic spine surgery
  • Degenerative spine
  • Lumbar spinal stenosis
  • Unilateral laminectomy and bilateral decompression
  • Visual analog scale

Cite this

@article{3cdcf0952d8a40449a84502352eca5b2,
title = "Is the Use of a Unilateral Biportal Endoscopic Approach Associated with Rapid Recovery After Lumbar Decompressive Laminectomy? A Preliminary Analysis of a Prospective Randomized Controlled Trial",
abstract = "Objective: The purpose of this study was to assess the immediate postoperative clinical outcomes and perform a preliminary analysis of the effectiveness of biportal endoscopic approaches to lumbar decompressive laminectomy in the treatment of lumbar spinal stenosis. Methods: All participants (64 patients) were randomly assigned in a 1:1 ratio to either the biportal endoscopic lumbar decompressive laminectomy (BE-D) group or the mini–open microscopic lumbar decompressive laminectomy (MI-D) group. Early postoperative outcomes were evaluated using clinical and surgical technique–related outcomes. The visual analog scale (VAS) pain score was measured at 6 time points after surgery (at 4, 8, 16, 24, and 48 hours and 2 weeks). Surgical technique–related outcomes were also analyzed. Results: There were no significant differences in the preoperative demographics between the 2 groups. The VAS pain score from 8 to 48 hours (P < 0.05) was significantly lower in the BE-D group than in the MI-D group. Moreover, the total amount of fentanyl usage was higher in the MI-D group than in the BE-D group after surgery (P = 0.026). The length of hospital stay was lower in the BE-D group than in the MI-D group (P = 0.048). The operative time and creatinine phosphokinase level were not significantly different between the groups (P >0.05). Postoperative drainage was significantly higher in the BE-D group than in the MI-D group. Conclusions: BE-D was associated with rapid pain recovery, low fentanyl usage, and early discharge after surgery, but its other benefits have not yet been shown.",
keywords = "Biportal endoscopic spine surgery, Degenerative spine, Lumbar spinal stenosis, Unilateral laminectomy and bilateral decompression, Visual analog scale",
author = "Park, {Sang Min} and Kim, {Gang Un} and Ho-Joong Kim and Choi, {Jae Heouk} and Boon-Soon Chang and Lee, {Choon Ki} and Yeom, {Jin Sup}",
year = "2019",
month = "8",
day = "1",
doi = "10.1016/j.wneu.2019.04.240",
language = "English",
volume = "128",
pages = "e709--e718",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

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TY - JOUR

T1 - Is the Use of a Unilateral Biportal Endoscopic Approach Associated with Rapid Recovery After Lumbar Decompressive Laminectomy? A Preliminary Analysis of a Prospective Randomized Controlled Trial

AU - Park, Sang Min

AU - Kim, Gang Un

AU - Kim, Ho-Joong

AU - Choi, Jae Heouk

AU - Chang, Boon-Soon

AU - Lee, Choon Ki

AU - Yeom, Jin Sup

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Objective: The purpose of this study was to assess the immediate postoperative clinical outcomes and perform a preliminary analysis of the effectiveness of biportal endoscopic approaches to lumbar decompressive laminectomy in the treatment of lumbar spinal stenosis. Methods: All participants (64 patients) were randomly assigned in a 1:1 ratio to either the biportal endoscopic lumbar decompressive laminectomy (BE-D) group or the mini–open microscopic lumbar decompressive laminectomy (MI-D) group. Early postoperative outcomes were evaluated using clinical and surgical technique–related outcomes. The visual analog scale (VAS) pain score was measured at 6 time points after surgery (at 4, 8, 16, 24, and 48 hours and 2 weeks). Surgical technique–related outcomes were also analyzed. Results: There were no significant differences in the preoperative demographics between the 2 groups. The VAS pain score from 8 to 48 hours (P < 0.05) was significantly lower in the BE-D group than in the MI-D group. Moreover, the total amount of fentanyl usage was higher in the MI-D group than in the BE-D group after surgery (P = 0.026). The length of hospital stay was lower in the BE-D group than in the MI-D group (P = 0.048). The operative time and creatinine phosphokinase level were not significantly different between the groups (P >0.05). Postoperative drainage was significantly higher in the BE-D group than in the MI-D group. Conclusions: BE-D was associated with rapid pain recovery, low fentanyl usage, and early discharge after surgery, but its other benefits have not yet been shown.

AB - Objective: The purpose of this study was to assess the immediate postoperative clinical outcomes and perform a preliminary analysis of the effectiveness of biportal endoscopic approaches to lumbar decompressive laminectomy in the treatment of lumbar spinal stenosis. Methods: All participants (64 patients) were randomly assigned in a 1:1 ratio to either the biportal endoscopic lumbar decompressive laminectomy (BE-D) group or the mini–open microscopic lumbar decompressive laminectomy (MI-D) group. Early postoperative outcomes were evaluated using clinical and surgical technique–related outcomes. The visual analog scale (VAS) pain score was measured at 6 time points after surgery (at 4, 8, 16, 24, and 48 hours and 2 weeks). Surgical technique–related outcomes were also analyzed. Results: There were no significant differences in the preoperative demographics between the 2 groups. The VAS pain score from 8 to 48 hours (P < 0.05) was significantly lower in the BE-D group than in the MI-D group. Moreover, the total amount of fentanyl usage was higher in the MI-D group than in the BE-D group after surgery (P = 0.026). The length of hospital stay was lower in the BE-D group than in the MI-D group (P = 0.048). The operative time and creatinine phosphokinase level were not significantly different between the groups (P >0.05). Postoperative drainage was significantly higher in the BE-D group than in the MI-D group. Conclusions: BE-D was associated with rapid pain recovery, low fentanyl usage, and early discharge after surgery, but its other benefits have not yet been shown.

KW - Biportal endoscopic spine surgery

KW - Degenerative spine

KW - Lumbar spinal stenosis

KW - Unilateral laminectomy and bilateral decompression

KW - Visual analog scale

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U2 - 10.1016/j.wneu.2019.04.240

DO - 10.1016/j.wneu.2019.04.240

M3 - Article

VL - 128

SP - e709-e718

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -