Efficacy Analysis Of Unilateral Biportal Endoscopic Lumbar Interbody Fusion For Lumbar Spinal Stenosis

Objective: To investigate the efficacy and radiological outcomes of unilateral biportal endoscopic lumbar interbody fusion(UBE-LIF)for lumbar spinal stenosis(LSS).Methods: The data of 63 patients with LSS retrospectively analyzed,who underwent UBE-LIF in the Department of Bone Oncology,the First Affiliated Hospital of Xinjiang Medical University from March 2021 to March 2022.There were 24 males and 39 females,aged(61.2 ±7.9)years(ranged 45-75 years).The operation time,intraoperative blood loss,postoperative drainage volume,ambulation time,postoperative hospital stay and complications were recorded.The clinical efficacy was evaluated by visual analog scale(VAS)scores of low back and leg,Japanese Orthopaedic Association(JOA)score,Oswestry disability index(ODI),and modified Macnab criteria.The radiological outcomes were evaluated by X-ray or CT was reviewed at 6 months postoperatively and at the final follow-up,and surgical segmental fusion was evaluated using Bridwell grading criteria.Results: The operation time was 100-195 minutes,with an average of(139.4 ±20.9)minutes.The intraoperative blood loss was 85-190 ml,with an average of(124.5 ± 21.6)ml.Postoperative drainage volume was 15-65 ml,with an average of(35.5 ± 10.3)ml.The ambulation time was 1-3 days,with an average of(1.7 ± 0.6)days.Postoperative hospital stay was 3-6 days,with an average of(4.5 ± 0.6)days.A total of 8 complications occurred,with an incidence of 12.69%.The VAS scores of low back and leg,JOA score,and ODI were significantly improved compared to those before the operation at each postoperative follow-up time point,and the differences were statistically significant(all P <0.05).The modified Macnab criteria evaluation at the final follow-up showed that the outcomes were excellent in 48 cases(76.19%),good in 8 cases(12.70%),fair in 7 cases(11.11%),and no patient showed poor outcomes,with a rate of excellent and good was 88.89%.At the 6-month postoperative follow-up,15 cases(23.80%)were classified as Bridwell gradeⅠ,20 cases(31.75%)as grade Ⅱ,24 cases(38.10%)as grade Ⅲ,4 cases(6.35%)as grade Ⅳ,respectively;at the final follow-up,58 cases(92.06%)were classified as Bridwell grade Ⅰ,5 cases(7.94%)as grade Ⅱ,and 0 cases as grade Ⅲ and Ⅳ,respectively.Conclusion: UBE-LIF is a safe and effective minimally invasive fusion procedure for the treatment of LSS with excellent efficacy and radiological outcomes,which can provide new treatment options for patients with LSS.