Minimally invasive biportal endoscopic spinal surgery for central canal stenosis in low-grade degenerative lumbar spondylolisthesis: clinical outcomes and implications: a retrospective observational study
- Author:
Wongthawat LIAWRUNGRUEANG
1
;
Ho-Jin LEE
;
Sang Bum KIM
;
Sang Hyeok LEE
;
Sang Shin LEE
;
Ju-Eun KIM
Author Information
- Publication Type:Clinical Study
- From:Asian Spine Journal 2025;19(2):242-251
- CountryRepublic of Korea
- Language:English
-
Abstract:
Methods:A total of 68 patients with symptomatic, low-grade DLS and moderate-to-severe central canal stenosis underwent ULBD using BESS. Patients were followed for at least 2 years. Clinical outcomes were measured using the Visual Analog Scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and the modified Macnab criteria for patient satisfaction. Radiological outcomes were assessed on the basis of sagittal translation from dynamic flexion–extension radiographs.
Results:The mean VAS score for back pain decreased from 3.8±2.4 preoperatively to 1.9±2.0 at the final follow-up, and the leg pain scores decreased from 6.4±1.8 to 2.3±2.0 (both p<0.05). The ODI score improved significantly from 48.9±15.7 preoperatively to 23.1±17.5 at the final follow-up (p<0.05). According to the modified Macnab criteria, 27.9%, 42.6%, 22.1%, and 7.4% of the patients reported excellent, good, fair, and poor outcomes. Radiological assessments indicated no significant changes in sagittal translation, supporting the preservation of spinal stability.
Conclusions:BESS with ULBD represents a safe and effective minimally invasive approach for treating low-grade DLS with central canal stenosis. It offers substantial symptom relief and functional improvement without jeopardizing spinal stability, making it a viable alternative to conventional fusion surgery.
