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"Lumbar spinal stenosis"

Original Articles

Degenerative

Real-Time Location System Assessment of Early Postoperative Recovery After Lumbar Decompression According to Surgical Approach
Sub-Ri Park, Jaenam Lee, Sujin Kwon, Namhoo Kim, Dong Won Kim, Dukyong Yoon, Kyoung Min Kim, Byung Ho Lee
Neurospine 2026;23(2):459-472.   Published online April 30, 2026
DOI: https://doi.org/10.14245/ns.26520018.0009

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Real-Time Location System Assessment of Early Postoperative Recovery After Lumbar Decompression According to Surgical Approach
Neurospine. 2026;23(2):459-472.   Published online April 30, 2026
DOI: https://doi.org/10.14245/ns.26520018.0009
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Real-Time Location System Assessment of Early Postoperative Recovery After Lumbar Decompression According to Surgical Approach
Neurospine. 2026;23(2):459-472.   Published online April 30, 2026
DOI: https://doi.org/10.14245/ns.26520018.0009
Close
Objective
To evaluate early postoperative mobility after lumbar decompression using real-time location system (RTLS)-derived objective metrics and to explore differences in mobility patterns between biportal endoscopic decompression and open decompression.
Methods
This retrospective cohort study included 323 patients who underwent lumbar decompression for degenerative lumbar spinal stenosis between March 2020 and May 2024. RTLS sensors embedded in wristbands continuously recorded patient mobility during postoperative days (PODs) 1–4. Primary RTLS-derived outcomes included total walking distance, mean walking speed, and active movement ratios (top 20% and top 50%). Between-group comparisons were performed using nonparametric tests. Propensity score matching and multivariable median quantile regression adjusting for age, American Society of Anesthesiologists physical status, and preoperative mobility were conducted.
Results
RTLS identified differences in early postoperative activity patterns between surgical approaches. In adjusted analyses, activity-intensity–based metrics, particularly the top 20% activity ratio, remained significantly higher in the biportal endoscopic decompression group across multiple PODs. Subgroup analyses demonstrated minimal differences after single-level decompression, whereas activity-based differences were more frequently observed in multilevel procedures.
Conclusion
RTLS-based continuous monitoring detected differences in early postoperative activity patterns following lumbar decompression. These findings support the role of RTLS as an objective tool for assessing early functional recovery in spine surgery.
  • 870 View
  • 38 Download

Epidemiology

Rates, Causes, and Predictive Factors of Hospital Readmissions After Spine Surgery for Lumbar Spinal Stenosis: A Nationwide Retrospective Cohort Study
Lingxiao Chen, Jiaming Ding, Zhuo Chen, David B. Anderson, Maja R. Radojčić, Ruiyuan Zheng, Qingyu Sun, Wenjian Yuan, Jiuxiao Sun, Runhan Fu, Baoyi Shi, Yujie Chen, Lei Qi, Hengxing Zhou, Shiqing Feng
Neurospine 2025;22(2):523-539.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2449316.658

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Rates, Causes, and Predictive Factors of Hospital Readmissions After Spine Surgery for Lumbar Spinal Stenosis: A Nationwide Retrospective Cohort Study
Neurospine. 2025;22(2):523-539.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2449316.658
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Rates, Causes, and Predictive Factors of Hospital Readmissions After Spine Surgery for Lumbar Spinal Stenosis: A Nationwide Retrospective Cohort Study
Neurospine. 2025;22(2):523-539.   Published online June 30, 2025
DOI: https://doi.org/10.14245/ns.2449316.658
Close
Objective
This study aimed to determine the rates, causes, and predictive factors of readmissions at different periods following spine surgery, up to 180 days.
Methods
This study utilized data from the 2018 to 2019 Nationwide Readmissions Database and included four postoperative periods: 0 to 7 days, 8 to 30 days, 31 to 90 days, and 91 to 180 days. The causes of readmissions and potential predictive factors were systematically identified. All analyses were performed for each period.
Results
For the 180,281 patients (mean age, 65.4 years) included, 2.4% were readmitted between 0 and 7 days, 3.5% between 8 and 30 days, 3.7% between 31 and 90 days, and 4.3% between 91 and 180 days (cumulative rates: 2.4%, 5.9%, 9.3%, and 12.1%, respectively). The causes of readmissions varied across different periods: surgical site-related causes predominated within the first 30 days, whereas nonsurgical site-related causes were more prevalent from 31 to 180 days; other surgical care complication (e.g., infection) was the most prevalent cause between 0 and 7 days (10.7%) and between 8 and 30 days (29.2%), while spondylopathies/spondyloarthropathy (e.g., spinal stenosis) were the leading causes between 31 and 90 days (12.6%) and between 91 and 180 days (17.5%). The predictive factors associated with readmissions also varied across different periods. For example, patients who underwent fusion was associated with a decreased risk of readmissions between 31 and 180 days (e.g., between 91 and 180 days: odds ratio [OR], 0.79; 95% confidence interval [CI], 0.72–0.86; p<0.001), rather than between 0 and 30 days (e.g., between 0 and 7 days: OR, 0.99; 95% CI, 0.90–1.08; p=0.81).
Conclusion
About 6% of patients with lumbar spinal stenosis who underwent spine surgery were readmitted within 30 days and 12% by 180 days. The causes of readmissions and predictive factors varied by period, providing valuable insights for quality improvement efforts and the burden of readmission reductions.

Citations

Citations to this article as recorded by  Crossref logo
  • Patients with primary thrombophilia on anticoagulation face increased mortality, thromboembolic events, and neurologic complications after laminectomy: a propensity-matched analysis
    Naasik Syed, Zuhair Zaidi, Muaz Wahid, Ronak Desai
    International Journal of Research in Orthopaedics.2026; 12(2): 314.     CrossRef
  • Frailty-Muscle Phenotypes Predict Outcomes After Lumbar Fusion in Adults Aged ≥75 Years: A Retrospective Cohort Study
    Ma Chao Guo, Xiangyu Li, Shuaikang Wang, Xiaolong Chen, Chao Kong, Yuxi Liu, Shibao Lu
    Neurospine.2026; 23(2): 242.     CrossRef
  • 10,540 View
  • 141 Download
  • 1 Web of Science
  • 2 Crossref

Minimally Invasive Spine Surgery

Comparison of 3 Different Endoscopic Techniques for Lumbar Spinal Stenosis: Comprehensive Radiological and Clinical Study
Abdullah Merter, Mustafa Özyıldıran, Motohide Shibayama, Zenya Ito, Shu Nakamura, Fujio Ito
Neurospine 2025;22(1):276-285.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2448864.432

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Comparison of 3 Different Endoscopic Techniques for Lumbar Spinal Stenosis: Comprehensive Radiological and Clinical Study
Neurospine. 2025;22(1):276-285.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2448864.432
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Comparison of 3 Different Endoscopic Techniques for Lumbar Spinal Stenosis: Comprehensive Radiological and Clinical Study
Neurospine. 2025;22(1):276-285.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2448864.432
Close
Objective
This study aimed to compare the clinical and comprehensive radiological outcomes of 3 types of endoscopic decompression surgery: unilateral biportal endoscopic lumbar decompression (UBELD), microendoscopic laminotomy (MEL), and percutaneous endoscopic lumbar decompression (PELD).
Methods
Patients with single-level lumbar spinal stenosis without instability were included in this multicenter retrospective study. Visual analogue scale (VAS) scores for each extremity, VAS back pain, and Japanese Orthopaedic Association (JOA) scores at preoperative and postoperative 1st, 6th, and 12th months were used as clinical outcome measures. In order to compare the radiological results of the patients, bilateral superior articular distance (SAD), bilateral lateral recess height (LR height), bilateral lateral recess angle (LR angle), and cross-sectional spinal canal area values were measured.
Results
Eighty patients in the UBELD group, 73 patients in the MEL group, and 62 patients in the PELD group were included in the study. There was a statistically significant improvement in VAS scores and JOA scores in all groups compared to the preoperative period. At the 12th month postoperatively, the highest lateral decompression values on the approach side were determined as MEL (SAD: 4.1 mm, LR angle: 38.8°, LR height: 4.0 mm), followed by UBELD (SAD: 3.6 mm, LR angle: 36.2°, LR height: 3.3 mm) and PELD (SAD: 3.0 mm, LR angle: 21.7°, LR height: 2.3 mm), respectively. For the contralateral side, the highest lateral recess decompression values were listed as UBELD > MEL > PELD.
Conclusion
Effective decompression can be performed using all endoscopic techniques in lumbar spinal stenosis. However lateral recess decompression values were found to be better in UBELD and MEL techniques, compared to PELD.

Citations

Citations to this article as recorded by  Crossref logo
  • Bispectral Index Monitoring in Endoscopic Lumbar Spine Surgery: Retrospective Analysis of Central Nervous System Complications
    Abdullah Merter, Mustafa Özyıldıran, Fatih Kurt, Menekşe Özçelik
    World Neurosurgery.2025; 200: 124230.     CrossRef
  • Comparison of 0-degree and 30-degree endoscopes in unilateral biportal endoscopic decompression for lumbar spinal stenosis: Which preserves the facet joint better?
    Abdullah Merter, Mustafa Özyıldıran
    Journal of Orthopaedic Surgery.2025;[Epub]     CrossRef
  • Cumulative Sum and Risk-Adjusted Cumulative Sum Analysis of the First-Year Learning Curve for Unilateral Biportal Endoscopy in a Neurosurgeon with Endoscopic Skull Base Experience
    Eren Yılmaz, Atakan Emengen, Aykut Gökbel, Ayse Uzuner, Mehmet Korkmaz, Sibel Balci, Abdullah Merter, Savas Ceylan
    World Neurosurgery.2025; 204: 124523.     CrossRef
  • 6,066 View
  • 232 Download
  • 3 Web of Science
  • 3 Crossref

Regular Issue

Exploring lncRNA Expression Patterns in Patients With Hypertrophied Ligamentum Flavum
Junling Chen, Guibin Zhong, Manle Qiu, Wei Ke, Jingsong Xue, Jianwei Chen
Neurospine 2024;21(1):330-341.   Published online January 29, 2024
DOI: https://doi.org/10.14245/ns.2346994.497
Correction in: Neurospine 2024;21(2):742

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Exploring lncRNA Expression Patterns in Patients With Hypertrophied Ligamentum Flavum
Neurospine. 2024;21(1):330-341.   Published online January 29, 2024
DOI: https://doi.org/10.14245/ns.2346994.497
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Exploring lncRNA Expression Patterns in Patients With Hypertrophied Ligamentum Flavum
Neurospine. 2024;21(1):330-341.   Published online January 29, 2024
DOI: https://doi.org/10.14245/ns.2346994.497
Close
Objective
Hypertrophy ligamentum flavum (LFH) is a common cause of lumbar spinal stenosis, resulting in significant disability and morbidity. Although long noncoding RNAs (lncRNAs) have been associated with various biological processes and disorders, their involvement in LFH remains not fully understood.
Methods
Human ligamentum flavum samples were analyzed using lncRNA sequencing followed by validation through quantitative real-time polymerase chain reaction. To explore the potential biological functions of differentially expressed lncRNA-associated genes, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. We also studied the impact of lncRNA PARD3-AS1 on the progression of LFH in vitro.
Results
In the LFH tissues when compared to that in the nonhypertrophic ligamentum flavum (LFN) tissues, a total of 1,091 lncRNAs exhibited differential expression, with 645 upregulated and 446 downregulated. Based on GO analysis, the differentially expressed transcripts primarily participated in metabolic processes, organelles, nuclear lumen, cytoplasm, protein binding, nucleic acid binding, and transcription factor activity. Moreover, KEGG pathway analysis indicated that the differentially expressed lncRNAs were associated with the hippo signaling pathway, nucleotide excision repair, and nuclear factor-kappa B signaling pathway. The expression of PARD3-AS1, RP11-430G17.3, RP1-193H18.3, and H19 was confirmed to be consistent with the sequencing analysis. Inhibition of PARD3-AS1 resulted in the suppression of fibrosis in LFH cells, whereas the overexpression of PARD3-AS1 promoted fibrosis in LFH cells in vitro.
Conclusion
This study identified distinct expression patterns of lncRNAs that are linked to LFH, providing insights into its underlying mechanisms and potential prognostic and therapeutic interventions. Notably, PARD3-AS1 appears to play a significant role in the pathophysiology of LFH.
  • 5,889 View
  • 89 Download
  • 1 Web of Science
Learning Curve and Complications of Unilateral Biportal Endoscopy: Cumulative Sum and Risk-Adjusted Cumulative Sum Analysis
Jinchao Xu, Dong Wang, Jidan Liu, Chengyue Zhu, Jianhang Bao, Wenshuo Gao, Wei Zhang, Hao Pan
Neurospine 2022;19(3):792-804.   Published online August 15, 2022
DOI: https://doi.org/10.14245/ns.2143116.558

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Learning Curve and Complications of Unilateral Biportal Endoscopy: Cumulative Sum and Risk-Adjusted Cumulative Sum Analysis
Neurospine. 2022;19(3):792-804.   Published online August 15, 2022
DOI: https://doi.org/10.14245/ns.2143116.558
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Learning Curve and Complications of Unilateral Biportal Endoscopy: Cumulative Sum and Risk-Adjusted Cumulative Sum Analysis
Neurospine. 2022;19(3):792-804.   Published online August 15, 2022
DOI: https://doi.org/10.14245/ns.2143116.558
Close
Objective
The purpose of this study was to investigate the learning curve and complications of unilateral biportal endoscopy (UBE) in the treatment of lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS).
Methods
This was a retrospective cohort analysis of 197 consecutive patients who received UBE unilateral laminotomy bilateral decompression (UBE-ULBD) or lumbar discectomy (UBE-LD) surgery, including 107 males and 90 females with an average age of 64.83 ± 14.29 years. Cumulative sum (CUSUM) and risk-adjusted cumulative sum analysis (RA-CUSUM) were used to evaluate the learning curve, with the occurrence of complications defined as surgical failure, and variables of different phase of the learning curve were compared.
Results
The cutoff point of learning curve of UBE surgery was 54 cases according to CUSUM analysis. The learning curve of UBE-ULBD and UBE-LD were divided into 3 phases. The first cutoff points were 31 and 12 cases, and the second cutoff point were 67 and 32 cases respectively. With the progress of the learning curve, the operation time and postoperative hospital stays decreased. The visual analogue scale and Oswestry Disability Index at the last follow-up were significantly lower than that before surgery. The incidence of surgical failure was 6.11% and began to decrease after the 89th case based on RA-CUSUM analysis. The surgical failure rate decreased from 10.11% to 2.78 after the 89th case with significant different.
Conclusion
UBE surgery is effective in the treatment of LDH and LSS with low incidence of complications. But a learning curve of at least 54 cases still required for mastering UBE surgery.

Citations

Citations to this article as recorded by  Crossref logo
  • Comparison of the Biportal Endoscopic Versus Tubular Approach for the Treatment of Lumbar Degenerative Disease: A Systematic Review and Meta-Analysis
    Mark Kurapatti, Alexander Yu, Hamza Ahmed, Charu Jain, Ryan Hoang, Gray W. Ricca, Junho Song, Daniel Berman, Joshua Lee, Samuel K. Cho
    Global Spine Journal.2026; 16(1): 794.     CrossRef
  • Learning Curve of Unilateral Biportal Endoscopy in Spinal Stenosis: A Neuromonitoring-Assisted Analysis
    Ali Gulec, Ebubekir Eravsar, Sadettin Ciftci, Selim Safali, Ali Özdemir, Fatih Durgut, Bahattin Kerem Aydin
    Global Spine Journal.2026; 16(1): 707.     CrossRef
  • Comparing Unilateral Biportal Endoscopic Discectomy Versus Microdiscectomy for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis
    Muhammad Hassan Waseem, Zain ul Abideen, Muneeba Ahsan, Rimsha Adnan, Arusha Hasan, Zoya Aamir, Mahrosh Kasbati, Pawan Kumar Thada, Brandon Lucke-Wold
    Global Spine Journal.2026; 16(5): 2452.     CrossRef
  • Meta-Analysis of Complications in Minimally Invasive Spine Surgery (2013–2024)
    Sean Inzerillo, Eesha Gurav, Chibuikem A. Ikwuegbuenyi, Noah Willett, Mousa Hamad, Ibrahim Hussain, Alan Hernández-Hernández, Galal Elsayed, Roger Härtl, Osama Kashlan
    Spine.2026; 51(3): E47.     CrossRef
  • The learning curve of percutaneous endoscopic interlaminar discectomy versus unilateral biportal endoscopic discectomy for lumbar disc herniation: a comparative study
    Jin Chen, Lisi Zhang, Zhihan Wang, Li Liu, Lei Wang
    Journal of Orthopaedic Surgery and Research.2026;[Epub]     CrossRef
  • Automated Surgical Phase Recognition in Unilateral Biportal Endoscopic Spine Surgery Using Deep Learning
    Takahiro Kitagawa, Yoshiomi Kobayashi, Keitaro Matsukawa, Shogo Hashimoto, Reo Shibata, Mitsuru Furukawa, Tsunehiko Konomi, Kanehiro Fujiyoshi, Yoshiyuki Yato, Masaya Nakamura
    Spine Open.2026;[Epub]     CrossRef
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    Xavier A. Santander, Martin N. Stienen, Stefan Motov, Héctor U. Quintanilla, Elsa González Pérez
    Acta Neurochirurgica.2026;[Epub]     CrossRef
  • Efficacy and safety of unilateral biportal endoscopy vs. percutaneous endoscopic interlaminar approach in lumbar disc herniation: A meta‑analysis​
    Yuhao Gao, Fangzheng He, Ji Wen, Shilei Qin, Pengfei Han, Yunfeng Xu
    Experimental and Therapeutic Medicine.2026; 31(3): 1.     CrossRef
  • Anatomical Validation and Technical Feasibility of Biportal Endoscopic Spinal Surgery Including Technical Notes in a Cadaveric Canine Thoracic Intervertebral Disc Disease Model
    Sung-Ho Lee, Ji-Hyun Park, Da-Eun Kim, Gunha Hwang, Chang-Hwan Moon, Dongbin Lee
    Animals.2026; 16(3): 435.     CrossRef
  • A retrospective study on the effects of unilateral biportal endoscopic lumbar interbody fusion on functional recovery in patients undergoing single-level lumbar interbody fusion
    Xinyun Huang, Shi Ling, Qi Cao
    Translational Neuroscience.2026;[Epub]     CrossRef
  • Comparative Cost Analysis
    Kern Singh, Andrea M. Roca, Fatima N. Anwar, Shriya N. Patel, Sloane O. Ward, Daniel K. Park
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  • Minimally invasive spine surgery: current advantages, limitations, and future directions
    Weonmin Cho, Soo-Bin Lee, Seong Ho Oh, Young-Seo Park, Kyung-Yil Kang
    Asian Spine Journal.2026;[Epub]     CrossRef
  • Percutaneous transforaminal endoscopic discectomy vs. unilateral biportal endoscopy for far lateral lumbar disc herniation: a retrospective comparative study
    Lu Yongjiang, Li Chunbo, Wang Jianyuan
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • Comparison of outcomes after unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy for lumbar disc herniation: a systematic review and meta-analysis of observational studies
    Abdullah Afridi, Ayesha Zulfiqar, Muhammad Waqar Shahid, Fatima Sajjad, Hamnah Sohail, Fazia Khattak, Sabir Khan, Ayesha Naseem, Alina Batool, Muhammad Muneeb, Savira Khattak, Izhar Ul Haq, Ayesha Shahid, Ayesha Nauman, Marium Nisar, Tanveer Hussain, Ahsa
    Egyptian Journal of Neurosurgery.2026;[Epub]     CrossRef
  • O‐Arm Navigation Enhances Facet Preservation Without Compromising Clinical Outcomes in UBE Decompression for Radiographically Stable Adult Degenerative Scoliosis: A Single‐Center Comparative Study
    Yi Liu, Yiwei Xie, Zhibao Chen, Ruijun Xu, Haojie Chen, Xiaojian Ye, Jiangming Yu
    Orthopaedic Surgery.2026; 18(6): 1203.     CrossRef
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    Xiao Min Cai, Guo Sen Li, Xiao Yang Nie, Da Liu, Chun Lin Xiao, Min Zhao, En Song, Jiang Jun Zhou
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • БИПОРТАЛЬНАЯ ЭНДОСКОПИЧЕСКАЯ ХИРУРГИЯ. КЛИНИЧЕСКИЕ РЕЗУЛЬТАТЫ ОПЕРАТИВНОГО ЛЕЧЕНИЯ 250 БОЛЬНЫХ С ПАТОЛОГИЕЙ ПОЗВОНОЧНИКА
    В.В. Ступак, Ш.А. Аул, А.Г. Бобылев, Ж.И. Жалолов, А.А. Абдурохмонов, О.И. Кузиев, М.В. Куценко, В.В. Кельмаков
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    Jose-Carlos Sauri-Barraza, Luis Enrique Nuñez-Alvarado, Eduardo Callejas-Ponce, Jorge Daniel Perez-Ruiz, Eugenio Carral-Robles-Leon, Carlo Enrico Bañuelos-Aluzzi, Luis Manuel Solis-Reyna, Jesus Ernesto Valdez-Aguilar, Francisco Garcia-Muñoz
    Brain and Spine.2026; 6: 106132.     CrossRef
  • Comparative Clinical and Radiological Outcomes of Arthroscopic‐Assisted Uniportal Spinal Surgery Versus Unilateral Biportal Endoscopy for Unilateral Laminotomy With Bilateral Decompression in Lumbar Spinal Stenosis: A 2‐Year Follow‐Up Study
    Abdul Waheed Bahir, Wang Daxing, Liu Bailian, Gan Xuewen, Xiong Ying, Xiao Jiayu, Gu Shao
    Orthopaedic Surgery.2026;[Epub]     CrossRef
  • Comparison of biportal versus uniportal endoscopic decompression for the treatment of lumbar degenerative disease: a systematic review and meta‑analysis
    Alexander Yu, Mark Kurapatti, Ryan Hoang, James Hong, Nancy Shrestha, Ryan Stadler, Peter Campbell, Junho Song, Joshua Lee, Samuel K. Cho
    Asian Spine Journal.2026; 20(3): 558.     CrossRef
  • Early Clinical and Radiologic Evaluation of Unilateral Biportal Endoscopic Unilateral Laminotomy and Bilateral Decompression in Degenerative Lumbar Spinal Stenosis: A Retrospective Study
    Jianjian Yin, Tao Ma, Gongming Gao, Qi Chen, Luming Nong
    Journal of Neurological Surgery Part A: Central European Neurosurgery.2025; 86(05): 428.     CrossRef
  • Learning Curve of Endoscopic Lumbar Discectomy – A Systematic Review and Meta-Analysis of Individual Participant and Aggregated Data
    Chan Hee Koh, James Booker, David Choi, Danyal Zaman Khan, Hugo Layard Horsfall, Parag Sayal, Hani J Marcus, George Prezerakos
    Global Spine Journal.2025; 15(2): 1435.     CrossRef
  • Short-term efficacy of unilateral biportal endoscopy technology in the treatment of cervical spondylotic radiculopathy
    Mohan Wen, Xu Li, Xiangjun Lu, Tianzuo Chen, Rujie Qin
    European Spine Journal.2025; 34(1): 118.     CrossRef
  • Comparative Study Between Unilateral Biportal Endoscopic Discectomy and Percutaneous Interlaminar Endoscopic Discectomy for the Treatment of L5/S1 Disc Herniation
    Jianjian Yin, Gongming Gao, Senlin Chen, Tao Ma, Luming Nong
    World Neurosurgery.2025; 194: 123526.     CrossRef
  • Learning curve insights in Unilateral Biportal Endoscopic (UBE) spinal procedures: proficiency cutoffs and the impact on efficiency and complications
    Jing Peng, Rongzhen Lin, Duopei Fang, Zhaojun He, Qinghao Zhao, Qingchu Li
    European Spine Journal.2025; 34(3): 954.     CrossRef
  • Delta large-channel endoscopy versus unilateral biportal endoscopy decompressive laminectomy for lumbar spinal stenosis: a prospective randomized controlled trial
    Rushuo Wei, Weiqiang Liu, Mingdong Yu, Yushan Zhu, Ruzhan Yao, Bingwu Wang, Jesse Li-Ling
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
  • Unilateral biportal endoscopic discectomy for lumbar disc herniation: Learning curve analysis with CUSUM analysis and clinical outcomes
    Oğuz Kağan Demirtaş, Mehmet İlker Özer
    Clinical Neurology and Neurosurgery.2025; 249: 108755.     CrossRef
  • Clinical and Radiological Comparison of Unilateral Biportal Endoscopic and Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Lumbar Spinal Degenerative Disease
    Hongtao Ding, Xiao Han, Yonggang Xing, Yajun Liu, Da He, Xiaoguang Han
    Orthopaedic Surgery.2025; 17(4): 1105.     CrossRef
  • What is the learning curve for endoscopic spine surgery? A comprehensive systematic review
    Justin P. Chan, Thomas Olson, Beshoy Gabriel, Sohaib Hashmi, Hao-Hua Wu, Hansen Bow, Yu-Po Lee, Nitin Bhatia, Michael Oh, Don Y Park
    The Spine Journal.2025;[Epub]     CrossRef
  • Comparison of Learning Curves and Clinical Outcomes in Unilateral Biportal Endoscopic Spinal Surgery Versus Percutaneous Transforaminal Endoscopic Surgery: A Cumulative Sum Analysis
    Shuo Yuan, Ruiyuan Chen, Yuqi Mei, Ning Fan, Tianyi Wang, Aobo Wang, Peng Du, Yu Xi, Lei Zang
    Journal of Pain Research.2025; Volume 18: 631.     CrossRef
  • Biportal Versus Uniportal Lumbar Decompression—Indications and Efficacy: A Review With Case Examples
    Felicia W. Sun, Ki-Eun Chang, Jian Shen, Albert E. Telfeian
    Neurosurgery.2025; 96(3S): S63.     CrossRef
  • Safety and Utility of Bilateral-contralateral Decompression for Adjacent Segment Stenosis After Lumbar Interbody Fusion Using Unilateral Biportal Endoscopy
    Dong Hyun Lee, Choon Keun Park, Jae-Won Jang, Dong-Geun Lee
    Clinical Spine Surgery.2025; 38(10): E488.     CrossRef
  • Learning curve for full-endoscopic lumbar decompression via interlaminar approach using the learning curve cumulative summation analysis
    Sung Cheol Park, Sang-Min Park, Hoon-Jae Chung, Yong Jin You
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
  • Clinical Efficacy of Biportal versus Uniportal Endoscopic Discectomy for Far Lateral Lumbar Disc Herniation: A Retrospective Study Analysis
    Zhang Zhiqiang, Yang Jiandong, Huang Zhi, Abdiaziz Ahmed Mohamed, Zhang Liang, Feng Xinmin
    World Neurosurgery.2025; 197: 123788.     CrossRef
  • The learning curve for lumbar discectomy in unilateral biportal endoscopic spine surgery using the cumulative summation method
    Takaki Yoshimizu, Sanshiro Saito, Teruaki Miyake, Tetsutaro Mizuno, Ushio Nosaka, Keisuke Ishii, Mizuki Watanabe, Kanji Sasaki
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
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    Haitao Sun, Qi Zhang, Kehan Xu, Zihuan Zhou, Dongjie Jiang, Shaohui He, Jilu Liu, Haifeng Wei
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Minimally Invasive Spine Surgery With Midline Cortical Bone Trajectory Screw Fixation for Lumbar Degenerative Disease in a Retrospective Study of 200 Patients
Sung Hyun Noh, Ho Yeol Zhang
Neurospine 2021;18(2):355-362.   Published online June 30, 2021
DOI: https://doi.org/10.14245/ns.2142016.008

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Minimally Invasive Spine Surgery With Midline Cortical Bone Trajectory Screw Fixation for Lumbar Degenerative Disease in a Retrospective Study of 200 Patients
Neurospine. 2021;18(2):355-362.   Published online June 30, 2021
DOI: https://doi.org/10.14245/ns.2142016.008
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Minimally Invasive Spine Surgery With Midline Cortical Bone Trajectory Screw Fixation for Lumbar Degenerative Disease in a Retrospective Study of 200 Patients
Neurospine. 2021;18(2):355-362.   Published online June 30, 2021
DOI: https://doi.org/10.14245/ns.2142016.008
Close
Objective
Midline lumbar interbody fusion is performed for treatment of various lumbar degenerative diseases, with good clinical outcomes and few complications. However, there are no large-scale or long-term studies regarding midline lumbar interbody fusion. Therefore, the purpose of this study was to evaluate the clinical results of midline lumbar interbody fusion and to compare the results according to surgical level.
Methods
Between January 2013 and December 2015, 200 patients with lumbar degenerative disease undergoing midline lumbar interbody fusion surgery were enrolled. The mean patient age was 69.9 ± 15.8 years (range, 40–85 years). The patients were divided into groups according to surgical level: (1) level 1 operation (136 patients), (2) level 2 operation (43 patients), (3) level 3 operation (12 patients), and (4) level 4 or higher (9 patients). Clinical outcomes, fusion rates, and complications were compared among the 4 groups.
Results
All clinical outcomes significantly improved after surgery (measured at 3 years postoperatively) in all groups. Mean fusion rate was 90.5% ± 5.21%. Fusion rate was highest in group I (95.8%) and lowest in group IV (85.2%). There were complications in 17 cases (8.5%). Adjacent segment disease occurred in 16 cases, 5 of which required surgery. Group 1 had 1 case, and group 4 had 4 cases. Screw loosening occurred in 1 case in group 4. There were no cases of infection or mechanical complications.
Conclusion
This large, single‐institution, retrospective study demonstrates favorable clinical outcomes after midline lumbar interbody fusion for lumbar degenerative disease regardless of surgical level.

Citations

Citations to this article as recorded by  Crossref logo
  • Open Midline Decompression with Ligament Reconstruction for Multiple-Level Spinal Stenosis in Elderly Patients
    Shin-Jae Kim, Sang-Ho Lee, Junseok Bae
    NeuroSci.2025; 6(1): 18.     CrossRef
  • Surgical stabilization for degenerative lesions of the lumbar spine in patients with reduced bone mineral density: a systematic literature review
    I. V. Shirokikh, A. I. Vasilyev, Yu. M. Batrak, V. A. Peleganchuk
    Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika).2024; 21(1): 44.     CrossRef
  • Postoperative urinary retention after oblique lumbar interbody fusion under the systematic management protocol
    Joonsoo Lim, Jangyeob Lim, Asfandyar Khan, Chang-Hyun Lee, Jun-Hoe Kim, Sejin Choi, Tae-Shin Kim, Yunhee Choi, Chun Kee Chung, Sangwook T. Yoon, Kyoung-Tae Kim, Chi Heon Kim
    Scientific Reports.2024;[Epub]     CrossRef
  • Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients
    Chih-Chang Chang, Hsuan-Kan Chang, Chin-Chu Ko, Ching-Lan Wu, Yi-Hsuan Kuo, Tsung-Hsi Tu, Wen-Cheng Huang, Jau-Ching Wu
    Neurospine.2023; 20(1): 308.     CrossRef
  • The Fusion Rate of Cortical Bone Trajectory Screw Fixation and Pedicle Screw Fixations in L4‐5 Interbody Fusion: A Retrospective Cohort Study
    Yuhe Lin, Jie Xu, Wu Zheng
    Orthopaedic Surgery.2023; 15(5): 1281.     CrossRef
  • Minimally invasive fusion surgery for patients with degenerative spondylolisthesis and severe lumbar spinal stenosis: a comparative study between MIDLIF and TLIF
    Pedro Santos Silva, Ana Jardim, Joana Pereira, Rita Sousa, Rui Vaz, Paulo Pereira
    European Spine Journal.2023; 32(9): 3210.     CrossRef
  • Cortical bone trajectory screws in the treatment of lumbar degenerative disc disease in patients with osteoporosis
    Song Guo, Kai Zhu, Mei-Jun Yan, Xin-Hua Li, Jun Tan
    World Journal of Clinical Cases.2022; 10(36): 13179.     CrossRef
  • 8,024 View
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  • 6 Web of Science
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Clinical Articles

Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis
Hee-Jong Hwang, Hyung-Ki Park, Gwang-Soo Lee, June-Young Heo, Jae-Chil Chang
Korean J Spine 2016;13(4):183-189.   Published online December 31, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.4.183

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Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis
Korean J Spine. 2016;13(4):183-189.   Published online December 31, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.4.183
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Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis
Korean J Spine. 2016;13(4):183-189.   Published online December 31, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.4.183
Close
Objective

The risk factors of reoperation after microdecompression (MD) for lumbar spinal stenosis (LSS) are unclear. In this study, we presented the outcomes of MD for degenerative LSS and investigated the risk factors associated with reoperation.

Methods

A retrospective review was conducted using the clinical records and radiographs of patients with LSS who underwent MD. For clinical evaluation, we used the Japanese Orthopedic Association (JOA) scoring system for low back pain, body mass index, and Charlson comorbidity index. For radiological evaluation, disc height, facet angle, and sagittal rotation angle were measured in operated segments. Also the Modic change and Pfirrmann grade for degeneration in the endplate and disc were scored.

Results

Forty-three patients aged 69±9 years at index surgery were followed for 48±25 months. The average preoperative JOA score was 6.9±1.6 points. The score improved to 9.1±2.1 points at the latest follow-up (p<0.001). Seven patients (16.3%) underwent reoperation. Clinical and radiological factors except operation level and Pfirrmann grade showed a p-value >0.1. Patients with Pfirrmann grade IV and lower lumbar segment had a 29.1% rate of reoperation (p=0.001), whereas patients without these factors had a 0% rate of reoperation.

Conclusion

Moderate disk degeneration (Pfirrmann IV) in lower lumbar segments is a risk factor of disk herniation or foraminal stenosis requiring reoperation after MD in LSS.

Citations

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    Jun Jae Shin, Keonhee Kim, Se Jun Park, Won Joo Jeong, Sun Joon Yoo, Dong Ah Shin, Joongkyum Shin, Hyun Jun Jang, Dong Kyu Chin
    Yonsei Medical Journal.2026; 67(3): 269.     CrossRef
  • Modified Minimally Invasive Transforaminal Microscope-Assisted Fusion to Treat Lumbar Foraminal Stenosis Combined with Severe Lumbar Degenerative Diseases
    Xu Li, Yongjin Sun, Guolin Tang, Buzhou Chen, Wenzhi Zhang
    World Neurosurgery.2025; 197: 123879.     CrossRef
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    Di Zhang, Jiawei Du, Jiaxiao Shi, Yundong Zhang, Siyue Jia, Xingyu Liu, Yu Wu, Yicheng An, Shibo Zhu, Dayu Pan, Wei Zhang, Yiling Zhang, Shiqing Feng
    JOR SPINE.2024;[Epub]     CrossRef
  • Impact of Preoperative Intervertebral Disc Degeneration on Patient-Reported Outcome Measures After Lumbar Fusion
    Omar H. Tarawneh, Rajkishen Narayanan, Delano Trenchfield, Yunsoo Lee, Tariq Z. Issa, Yoni Dulitzki, Bahram Pashaee, Krisna Maddy, Hannah Bash, Gokul Karthikeyan, lan David Kaye, John J. Mangan, Jose A. Canseco, Alan S. Hilibrand, Alexander R. Vaccaro, Ch
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Risk Factors and Incidence for Peripheral Arterial Disease in Patients with Typical Lumbar Spinal Stenosis
Min-Hee Han, Dong-Hyun Lee, Ki-Su Park, Young-Seok Lee, Kyoung-Tae Kim, Joo-Kyung Sung, Hyung-Kee Kim, Dae-Chul Cho
Korean J Spine 2014;11(3):183-187.   Published online September 30, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.3.183

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Risk Factors and Incidence for Peripheral Arterial Disease in Patients with Typical Lumbar Spinal Stenosis
Korean J Spine. 2014;11(3):183-187.   Published online September 30, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.3.183
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Risk Factors and Incidence for Peripheral Arterial Disease in Patients with Typical Lumbar Spinal Stenosis
Korean J Spine. 2014;11(3):183-187.   Published online September 30, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.3.183
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Objective

Intermittent claudication (IC) is a typical symptom of peripheral arterial disease (PAD) and lumbar spinal stenosis (LSS). In order to prevent misdiagnosis of vascular disease, it is important to know the incidence of and risk factors for PAD in patients with LSS. Therefore, the aim of our study was to evaluate the incidence of and risk factors for PAD in patients with typical and severe LSS who underwent spinal surgical treatment.

Methods

The occurrence of PAD was examined retrospectively in 171 consecutive patients with LSS and severe IC who underwent surgical treatment at our hospital from June 2012 to June 2013. Data were collected on background characteristics (sex, age) and known risk factors for PAD, such as hypertension, diabetes mellitus, smoking, hyperlipidemia, stroke, and ischemic heart disease.

Results

Of the 171 patients enrolled, 7 had an abnormal ankle-brachial index (ABI). Computed tomography angiography (CTA) was performed in these patients, and a final diagnosis of PAD was established for all 7 patients. The incidence of PAD in all patients with LSS was 4.1%(7 of 171). Stroke and ischemic heart disease were significantly more common in the LSSPAD group compared with the LSS group. Multiple logistic regression analyses with a forced-entry method revealed that age and stroke (p<0.05) were independent risk factors for PAD.

Conclusion

To prevent misdiagnosis of fatal PAD, we recommend ABI be assessed in patients with LSS and history of stroke.

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    Journal of Clinical Medicine.2022; 11(19): 5550.     CrossRef
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    Luke Boylan, Craig Nesbitt, Lesley Wilson, John Allen, Andrew Sims, Ina Guri, Philip Mawson, Crispian Oates, Gerard Stansby, On Behalf of the NOTEPAD Investigators
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    Spinal Surgery.2020; 34(2): 169.     CrossRef
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  • The Effect of Lumbar Spinal Stenosis on Results of Treatment in Peripheral Arterial Disease
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Original Article

Outcomes of Unilateral Approach for Bilateral Decompression of Lumbar Spinal Stenosis: Comparison between Younger and Geriatric Patients.
Sang Won Hwang, Seung Chul Rhim, Sung Woo Roh, Sang Ryong Jeon, Seung Jae Hyun
Korean J Spine 2008;5(2):51-57.

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Outcomes of Unilateral Approach for Bilateral Decompression of Lumbar Spinal Stenosis: Comparison between Younger and Geriatric Patients.
Korean J Spine. 2008;5(2):51-57.
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Outcomes of Unilateral Approach for Bilateral Decompression of Lumbar Spinal Stenosis: Comparison between Younger and Geriatric Patients.
Korean J Spine. 2008;5(2):51-57.
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OBJECTIVE
The purpose of our retrospective study is to evaluate the surgical outcome of patients who underwent unila- teral approach for bilateral decompression surgery for lumbar spinal stenosis and to compare outcomes between geriatric and younger patients.
METHODS
We reviewed records of 85 patients with an average age of 64 years at the time of surgery after the unilateral laminotomy for bilateral decompression of degenerative lumbar spinal stenosis between 2005 and 2007. To compare clinical and functional outcomes between younger and geriatric patients, they were divided by age into 2 groups: Group A included patients 65 years of age or older and Group B contained patients younger than 65 years. The study parameters were set to ensure a follow-up period of at least 3 months and hospital records and phone-call review were analyzed for patients' clinical and demographic data, co-morbidity, type of stenosis, clinical and functional outcomes. Clinical outcomes were measured using the scale of Finneson and Cooper and the visual analog scale score for leg and back pain. Functional outcome was assessed with change of walking distance of patients.
RESULTS
Follow-up was completed in 80(94.1%) of 85 patients and Group A included 44 patients and Group B did 36 patients. The number of decompressed level showed 2.26 with similar results in both groups(group A, 2.25; Group B, 2.28). The number of co-morbidity was significantly higher incidence of 2.36 in geriatric patients than that of 1.67 in younger individuals. Other demographic data and type of stenosis were similar between two groups. For each back and leg pain, 86.3%(Group A: 86.4%; Group B, 80.6%) and 83.8%(Group A: 90.9%; Group B: 80.6%) had an excellent-to-fair operative result under the scale of Finneson and Cooper. Improvement rate of walking distance was 81.5% of patients and higher in group B(89.3%) than in group A(75.6%), however, there was not statistical significance. Three major complications were occurred in all patient groups, the first patient with chronic renal failure suffered from immediately postoperative epidural hematoma and the second patient had wound dehiscence. The third patient with no improvement was operated with fusion surgery at the other hospital nonetheless she had not improved until now.
CONCLUSIONS
The ULBD allowed sufficient and safe decompression of the neural structures and adequate preservation of vertebral stability with acceptable complication rates. This technique could provide a minimally invasive approach for LSS in elderly patients frequently having comorbidities as well as younger one.
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