Comparison of the short-term effects of lumbar endoscopic and microscopic tubular unilateral laminotomy with bilateral decompression in the treatment of elderly patients with lumbar spinal stenosis

Abstract

Objective: To compare the clinical efficacy of lumbar endoscopic Delta large channel and microscopic tubular Quadrant channel unilateral laminotomy with bilateral decompression in the treatment of elderly patients with lumbar spinal stenosis. Methods: A total of 40 patients aged above 75 years with lumbar spinal stenosis admitted from June 2019 to August 2021 were reviewed, in which the observation group was treated with the Delta large channel technique and the control group was treated with Quadrant channel open decompression. The general data, duration of illness, operation time, intraoperative bleeding, VAS score preoperatively, 3 days postoperatively, 3 months postoperatively and 6 months postoperatively, and ODI index of the two groups were recorded in the two groups. Results: The observation group had significantly shorter operation time (59.93 ± 10.46 min vs 77.66 ± 12.44 min, P < 0.001) and less intraoperative bleeding (21.06 ± 4.59 mL vs 51.00 ± 10.02 mL, P < 0.001) than the control group. There were no significant differences between the two groups in the duration of illness (11.85 ± 5.08 years vs 13.80 ± 7.40 years, P = 0.337), VAS score preoperatively (6.05 ± 1.19 vs 6.40 ± 1.47, P = 0.412), 3 days postoperatively (1.90 ± 0.85 vs 2.00 ± 1.08, P = 0.746), 3 months postoperatively (1.10 ± 0.31 vs 1.20 ± 0.41, P = 0.389) and 6 months postoperatively (1.25 ± 0.44 vs 1.30 ± 0.57, P = 0.759), and ODI index preoperatively (0.78 ± 0.07 vs 0.74 ± 0.07, P = 0.09), 3 months postoperatively (0.28 ± 0.06 vs 0.30 ± 0.05, P = 0.189) and 6 months postoperatively (0.21 ± 0.07 vs 0.22 ± 0.04, P = 0.444) (P > 0.05). The ODI index 3 days postoperatively in the observation group was significantly lower than that in the control group (0.33 ± 0.06 vs 0.37 ± 0.05, P = 0.022). Conclusion: Both surgical methods had good clinical outcomes for the treatment of lumbar spinal stenosis. However, Delta large channel endoscopy had a clearer vision, less trauma and lower incidence of early postoperative back pain than that of Quadrant channel open decompression.