Comparison of treatment outcomes and analysis of factors interfering with efficacy in patients with lumbar spinal stenosis undergoing unilateral unichannel and bichannel endoscopic ULBD surgery.

OBJECTIVE

To compare the treatment outcomes of unilateral unichannel and bichannel endoscopic Unilateral Laminotomy for Bilateral Decompression (ULBD) surgery in patients with lumbar spinal stenosis and analyze factors interfering with efficacy.

METHODS

This retrospective study included a total of 122 patients diagnosed with lumbar spinal stenosis who were treated at Bozhou District People's Hospital between June 2022 and June 2024. The patients were divided into two groups based on their surgical procedure: the unichannel endoscopic ULBD group (n = 61) and the bichannel endoscopic ULBD group (n = 61). Clinical outcomes, perioperative indicators, postoperative recovery metrics, foraminal area, cross-sectional area of the dural sac, complication rates, surgical satisfaction, and factors interfering with surgical efficacy were retrospectively analyzed.

RESULTS

No significant difference in the overall effectiveness rate between the two groups (P > 0.05). The bichannel group had shorter incision length, less blood loss, and a shorter surgery time compared to the unichannel group (P < 0.05). At postoperative days 3, 3 months, and 6 months, the VAS scores for back pain and leg pain, as well as the ODI scores in the bichannel group, were significantly lower than those in the unichannel group (P < 0.05), whereas the JOA scores were higher (P < 0.05). One month postoperatively, the cognitive, physical, role, and social function scores in the bichannel group were higher than those in the unichannel group (P < 0.05), and both the foraminal area and cross-sectional area of the dural sac were greater in the bichannel group (P < 0.05). The complication rate in the bichannel group was lower than that in the unichannel group (P < 0.05), and the surgical satisfaction rate was higher in the bichannel group (P < 0.05). Factors interfering with efficacy included age, duration of illness, intramedullary signal edema type, cystic type, preoperative annulus fibrosus rupture, and lumbar instability (P < 0.05).

CONCLUSION

Bichannel endoscopic ULBD surgery yields superior outcomes compared to unichannel surgery in lumbar spinal stenosis patients. Age, disease duration, and certain preoperative conditions are significant factors influencing efficacy.