Biportal endoscopic versus microscopic lumbar decompressive laminectomy in patients with spinal stenosis: a randomized controlled trial.
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2020;8(8):10 Spine J. 2020 Feb;20(2):156-165.What this means for my practice?
Study results suggest no significant difference in pain, functional or surgical outcomes between microscopic lumbar and biportal endoscopic decompressive laminectomy for the treatment of lumbar spinal stenosis. This study was limited by the lack of long-term follow up and small sample size.
Study Summary
Sixty-four patients with degenerative lumbar spinal stenosis were randomized to receive a biportal endoscopic or microscopic lumbar decompressive laminectomy. The primary outcome of interest was Oswestry Disability Index (ODI) scores at 12 months post-operation. Secondary outcomes of interest included back and leg pain on a Visual Analog Scale (VAS), EQ-5D quality of life scores, painDETECT scores, and ODI scores up to 12 months post-operation. Results revealed no significant differences in all outcomes at all time-points between the two groups with exception of drainage volume, which was significantly lower in the microscopic lumbar group.
Why was this study needed now?
Lumbar stenosis leads to significant pain and functional deficit, in many cases requiring surgical treatment via decompressive laminectomy. Microscopic lumbar decompressive laminectomy has been reported to improve clinical outcomes compared to conventional surgical intervention in patients with lumbar spinal stenosis, however recently biportal endoscopic decompressive laminectomy has been introduced as an alternative surgical method. The aim of this study was to compare the two methods of decompressive laminectomy in patients with degenerative lumbar spinal stenosis.
What was the principal research question?
In patients with degenerative lumbar spinal stenosis, how does a biportal endoscopic decompressive laminectomy compare to microscopic lumbar decompressive laminectomy with regards to patient-reported function, 12 months post-operation?
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