Clinical Outcomes of Spinal Canal Decompression Using Unilateral Biportal Endoscopic Spine Surgery for Elderly Degenerative Scoliosis Patient with Lumbar Stenosis

Difeng Zhang, Bao Xuexun

Abstract


This study aims to investigate the clinical effectiveness of unilateral biportal endoscopy (UBE) in the treatment, prevention and management of lumbar spinal stenosis caused by senile scoliosis. From May 2019 to May 2023, we used UBE technology to treat 57 cases of elderly scoliosis-induced lumbar spinal stenosis. The responsible segments included 14 cases at L3/4, 20 cases at L4/5, and 23 cases at L5/S1. Subjective assessment of pain intensity and the functional status of the lumbar spine was conducted using the Visual Analogue Scale (VAS) and the Japanese Orthopaedic Association (JOA). Evaluations were performed preoperatively, as well as 1-day, 3- and 12-month postoperatively. The Nakai classification system was employed for evaluating the therapeutic outcome at the final follow-up. All patients were followed-up, and at 3 and 12 months post-surgery, the JOA and VAS scores were significantly lower than those before surgery, with the scores at 12 months post-surgery being significantly lower than those at 3 months post-surgery (p < 0.05). The surgical excellence rate was as follows: 34 cases were excellent, 18 cases were good and 5 cases were fair. During the operation, dural tears occurred in five cases, with small tears and no cauda equina herniation was detected. Therefore, no special treatment was administered and no cerebrospinal fluid leakage occurred during the postoperative follow-up period. Local sensory numbness occurred in the plantar region of the affected limbs in 19 cases, with symptoms disappearing in four cases after the removal of the drainage tube postoperatively. In the remaining 15 cases, residual symptoms were alleviated with anti-inflammatory and analgesic medications. Until the final follow-up, there were no cases of recurrence or sudden lumbar disc relapse. Unilateral Biportal Endoscopic techniques offer a more convenient and clearer surgical field without significantly impairing the paraspinal muscles. This approach facilitates minimally invasive spinal surgery for elderly patients with scoliosis-related spinal stenosis who are unable to tolerate traditional open surgeries.


Keywords


Elderly scoliosis; minimally invasive lumbar surgery; spinal stenosis; unilateral biportal endoscopic

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DOI: http://dx.doi.org/10.17576/JSA.2026.1602.01

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