| Objective: The purpose of this study was to compare the short-term efficacy and imaging results of posterior unilateral biportal endoscopic unilateral laminectomy for bilateral decompression(UBE-ULBD)with minimally invasive channel microscopic unilateral laminotomy for bilateral decompression(Mi-ULBD)in patients with single-level lumbar spinal canal stenosis.Materials and methods: According to the following criteria,38 patients who underwent surgical treatment for single-level degenerative lumbar spinal stenosis in the Spinal Surgery Department of the First Affiliated Hospital of Jinan University from May 2018 to December 2021 were selected as the subjects for retrospective analysis.According to the operation type,the patients were divided into UBE-ULBD and MI-ULBD groups.Operation time,postoperative activity time and perioperative complications were recorded and statistically compared between the two groups.Visual analogue scales(VAS),Oswestry disability Index(Oswestry disability Index),modified Mac Nab clinical efficacy criteria were recorded before surgery,2 days after surgery,and 3 months after surgery;Serum C-reactive Protein(CRP),Creatine kinase(CK),Hemoglobin(Hb),Hematocrit(Hct)before and on day 2 after surgery;Dural sac cross-sectional area(DSCA)and cauda equina nerve root in Schizas in the Dural sac were measured by lumbar MRI before and 3days after surgery.The level of disc space and the width of bilateral inferior facet at the level of upper endplate of lower vertebral body were evaluated by lumbar CT before and on day 3 after surgery.Results: 1.The operative time of patients in the UBE-ULBD group was significantly better than those in the Mi-ULBD group(P < 0.05),and there was no statistical significance in the postoperative activity time and perioperative complications between the two groups(P > 0.05).2.CK in UBE-ULBD group was significantly lower than that in Mi-ULBD group on day 2 after surgery(P < 0.05),and CRP,CK,Hb and Hct in both groups were significantly changed on day 2after surgery compared with those before surgery(P < 0.05).3.VAS,ODI and modified Mac Nab scores of both groups on day 2 and 3 months after surgery were significantly changed compared with those before surgery(P < 0.05),and there was no statistical significance between the two groups(P > 0.05).4.The DSCA value and average DSCA expansion area of lumbar MRI in both groups on the third day after surgery were significantly improved compared with that before surgery(P < 0.05),and there was no statistical significance between the two groups(P > 0.05).5.The average morphologic extension area of cauda equina nerve root Schizas on lumbar MRI on the third day after surgery was significantly improved in both groups compared with that before surgery(P < 0.05),and there was no statistical significance in the degree of improvement between the two groups(P > 0.05).6.The retention rate of ipsilateral yellow intervertebral facet joint and retention rate of ipsilateral inferior endplate facet joint in lumbar CT of UBE-ULBD group on day 3 after surgery were significantly better than that of Mi-ULBD group(P < 0.05).There was no statistically significant difference in the retention rate of contralateral disc interstitial facet joint and contralateral superior endplate facet joint(P > 0.05).The retention rate of contralateral facet joint was greater than that of ipsilateral facet joint in both groups on the 3rd postoperative day,and the difference was statistically significant(P < 0.05).Conclusion: Both UBE-ULBD and Mi-ULBD are effective clinical procedures for the treatment of single-segment degenerative lumbar stenosis,with similar efficacy and less trauma as conventional open surgery.The efficacy of the two methods is similar,but UBE-ULBD has the following advantages compared with Mi-ULBD:(1)Shorter operation time;(2)Less damage to paravertebral muscle tissue;(3)The retention rate of ipsilateral facet joint was higher. |
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