オカザキ　ケン   Okazaki Ken   岡崎　賢    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Lumbar endoscopic unilateral laminotomy for bilateral decompression for lumbar spinal stenosis provides comparable clinical outcomes in patients with and without degenerative spondylolisthesis.
掲載誌名	正式名：World neurosurgery 略　 称：World Neurosurg ISSNコード：18788769/18788750
掲載区分	国外
巻・号・頁	pp.1
著者・共著者	YOSHIKANE Koichi, KIKUCHI Katsuhiko, OKAZAKI Ken
担当区分	責任著者
発行年月	2021/03
概要	OBJECTIVE:To investigate and compare the clinical and radiological outcomes of lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) for lumbar spinal stenosis (LSS) patients with and without degenerative spondylolisthesis (DS).METHODS:A total of 129 patients who underwent LE-ULBD for single-level LSS were retrospectively reviewed. The patients were classified into two groups based on presence of DS. Clinical outcomes were assessed with the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and numeric rating scale (NRS) for low back pain, lower limb pain, and lower limb numbness. Scores were obtained at baseline and final follow-up (mean follow-up, 28.6 months [range, 24-63]).RESULTS:The follow-up rate was 77.5% (103 patients). All domains of the JOABPEQ and NRS evaluations significantly improved during the follow-up period in both groups; group differences were not significant except for postoperative NRS limb numbness score, which was higher in patients with DS. Macnab outcome classification was excellent or good in 80% of patients without DS and 77.1% of patients with DS. During the follow-up period, increase of vertebral slip was observed in 31% of the patients with DS that includes vertebral slip progression defined as percent slip > 5% in 4% of the patients. The increase of vertebral slip was not related to clinical outcome. Segmental motion of the affected intervertebral disc did not increase after surgery.CONCLUSIONS:LE-ULBD provides comparably favorable outcome in LSS patients with and without DS. Postoperative segmental instability did not occur in patients with DS.
DOI	10.1016/j.wneu.2021.03.018
PMID	33722714