Background: Lumbar decompressive surgery is a standard surgical technique for lumbar spinal stenosis. Many new surgical techniques have been introduced, ranging from open surgery to minimally invasive procedures. Minimally invasive surgical techniques are preferred because patients experience less postoperative pain and shorter hospital stays. However, the success rate of minimally invasive techniques have been controversial. The object of this study was to assess the feasibility of spinal decompression using biportal technique/endoscopic surgery compared with microscopic surgery. Methods: Seventy lumbar spinal stenosis patients undergoing laminectomy were included in this study. A number table was used to randomize the patients into two groups: a biportal technique/endoscopic surgery group (BG-36) and a microscopic surgery group (OG-34). One surgeon performed either biportal technique/endoscopic decompression or microscopic decompression using a tubular retractor, depending on the group to which the patient was randomized. Perioperative data and clinical outcomes at postoperative 6 months were collected and analyzed. Results: The demographic data and level of surgery were comparable between the two groups. A shorter operation time (36 ± 11 vs 54 ± 9 min), less hemovac drain output (25.5 ± 15.8 vs 53.2 ± 32.1 ml), less opioid usage (2.3 ± 0.6 vs 6.5 ± 2.5 T) and shorter hospital stay (1.2 ± 0.3 vs 3.5 ± 0.8 days) were shown in BG. The BG experienced no significant differences in clinical outcomes compared with OG. Favorable clinical outcomes were shown at 6 months after surgery in both groups. Conclusion: Lumbar decompressive surgery using biportal technique/endoscopy showed favorable clinical outcomes, less pain and a shorter hospital stay compared to microscopic surgery in patients with lumbar spinal stenosis.
(http://creativecommons. org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.The worldwide population of the elderly is steadily increasing, and even more so in Korea, thus causing an increase in the osteoporotic fracture prevalence. Osteoporotic fracture is a serious injury that can decrease quality of life, and can also produce major social problems when it causes mortality. Preventing such fractures from happening in the first place is of utmost importance but once a fracture does occur, it is important to select appropriate treatment modalities to prevent secondary fractures. Recently, with the increase of life expectancy, it has become favorable to perform surgical fixation for significantly displaced osteoporotic fractures and use early rehabilitation programs to return the patient to normal body performance as soon as possible. To do so, it is important to accurately assess the location and the degree of the fractures in order to select appropriate treatment modalities. Furthermore, it is important to prevent secondary fractures from happening once the previous fractures heal.
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