Comparison of the results of open PLIF versus UBE PLIF in lumbar spinal stenosis: postoperative adjacent segment instability is lesser in UBE

Abstract

Objective To compare the difference in efficacy between open PLIF and UBE for lumbar spinal stenosis and the effect on postoperative adjacent segment instability. Method The clinical data of 37 patients with PLIF and 32 patients with UBE for lumbar spinal stenosis were retrospectively analyzed to compare the differences in perioperative conditions and short- and medium-term outcomes. Results All 69 patients completed the surgery successfully. The operating time, number of intraoperative fluoroscopies and hospital days were higher in the UBE group than in the open PLIF group. Intraoperative bleeding and postoperative drainage were lower than in the open PLIF group (P < 0.05). The visual analogue scale (VAS) of low back pain was lower in the UBE group than in the open PLIF group at 1 month and 3 months postoperatively (P < 0.05), and there were no statistically significant VAS scores for low back pain in the two groups at 1 day and 6 months postoperatively (P > 0.05). Leg pain VAS scores were lower in the UBE group than in the open PLIF group at 1 month, 3 months and 6 months postoperatively (P < 0.05), and leg pain VAS scores were not statistically significant in both groups at 1 day postoperatively (P > 0.05). The ODI index was lower in the UBE group than in the open PLIF group at 1 day and 1 month postoperatively (P < 0.05) and was not statistically significant in the two groups at 3 months and 6 months postoperatively (P > 0.05). There was no statistically significant difference between the two groups in postoperative interbody height, sagittal diameter of the spinal canal, efficacy of modified MacNab and interbody fusion (P > 0.05). The open PLIF group was more prone to postoperative adjacent vertebral instability than the UBE group, and the difference was statistically significant (P < 0.05). Conclusion With appropriate indications, the open PLIF group and the UBE group had similar short- and medium-term clinical outcomes for the treatment of lumbar spinal stenosis, but patients in the UBE group had better symptomatic improvement than the open PLIF group at 3 months postoperatively, and the effect on postoperative adjacent vertebral instability was smaller in the endoscopic group than in the open PLIF group.

The Method of Portal Making in Lumbar Unilateral Biportal Endoscopic Surgery with Different Operative Approaches According to the Constant Anatomical Landmarks of the Lumbar Spine: A Review of the Literature

“…A total of 568 studies were omitted from the remaining 1128 due to their non-compliance with the study’s objectives, such as their classification as non-original research articles, and so on. The remaining 560 studies underwent a comprehensive text evaluation, which led to the exclusion of 479 studies, and 25 studies that satisfied the inclusion criteria 5 - 29 were included. To ensure the integrity of the data, a screening of included studies in recent UBE reviews 30 - 33 and identified 4 additional studies that were subsequently incorporated into this research.…”

“…Therefore, a suggestion from Li has been put out to relocate the portals of the UBE-PLIF approach outward. 29 Unfortunately, Li’s study does not include details about the position used for the endoscope and working portals, and the account only mentions the pedicle as the anatomical reference. 29 Nevertheless, it is essential to acknowledge that the UBE-PLIF approach, which involves moving the incision outward, is increasingly gaining favor among surgeons.…”

Comparison of safety and efficacy of posterior lumbar interbody fusion (PLIF) and modified transforaminal lumbar interbody fusion (M-TLIF) in the treatment of single-segment lumbar degenerative diseases

“…The common lumbar degenerative diseases are lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis, scoliosis and so on [ 2 ]. At present, for lumbar degenerative diseases, patients with mild clinical symptoms are mainly treated with conservative treatment, but for lumbar degenerative diseases with severe pain, long-term conservative treatment is ineffective, seriously affect daily life, often need surgical treatment [ 3 ]. Lumbar fusion surgery is considered to be an effective treatment, which can significantly improve patients' symptoms such as low back and leg pain, and improve their quality of life [ 4 ].…”