Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Abstract
Unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE‐TLIF) is a minimally invasive procedure widely used to treat lumbar degenerative diseases. However, traditional techniques such as piecemeal resection of the ligamentum flavum are associated with a risk of complications, including dural tears and nerve root injuries. This study aimed to evaluate the clinical outcomes and safety of a modified UBE‐TLIF technique involving en bloc resection of the ligamentum flavum for bilateral decompression. A retrospective analysis was conducted on 85 patients who underwent single‐level UBE‐TLIF between January 2022 and December 2023. Patients were divided into two groups: Group A (n=42) underwent en bloc resection, while Group B (n=43) underwent piecemeal resection. Clinical outcomes, including Visual Analog Scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI), and fusion rates, were assessed preoperatively and at a 1‐year follow‐up. Perioperative parameters and complications were also analyzed. Both groups demonstrated significant improvements in VAS and ODI scores. Group A showed slightly better outcomes, with VAS back pain reduced from 6.7±0.9‐1.2±0.5 and ODI improved from 71.2±6.8%‐16.1±3.0%. Group B achieved similar improvements, but with slightly higher residual pain and disability. Fusion rates were comparable (Group A: 95.2%, Group B: 94.7%., p=0.93). Complications were significantly lower in Group A, with no cases of nerve root injuries or dura tears, compared to four cases in Group B (p=0.04). Group A also demonstrated marginally shorter operation times and reduced blood loss. The en bloc resection technique in UBE‐TLIF offers a safer alternative to traditional piecemeal resection, with comparable clinical outcomes and reduced complications. This innovative approach provides controlled decompression and enhances the safety profile of minimally invasive spine surgery, making it a promising technique for managing lumbar degenerative diseases. Further studies are warranted to confirm these findings in larger, multicenter trials.
How to cite this article:
K.C. Mathew, T. Uvarajan and S. Kavin Raja. Advancing Minimally Invasive Spine Surgery: En Bloc Ligamentum Flavum Resection in UBE‐TLIF for Improved Outcomes in Lumbar Degenerative Disease.
DOI: https://doi.org/10.36478/makrjms.2024.11.664.668
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2024.11.664.668