Preliminary Clinical and Radiological Outcomes of the “No- ...

Preliminary Clinical and Radiological Outcomes of the “No-Punch” Decompression Technique

The “No-Punch” decompression technique for unilateral biportal endoscopy (UBE) serves as a novel approach in spinal surgeries, particularly for patients experiencing conditions such as axial back pain, radicular leg pain, single or multiple lumbar radiculopathies, and neurogenic intermittent claudication due to degenerative lumbar spinal stenosis (DLSS). Prior to surgical intervention, all patients must undertake at least three months of conservative treatments. For a thorough assessment, patients underwent imaging studies, including plain X-rays (anteroposterior, lateral, and dynamic views) and magnetic resonance imaging (MRI), both pre-surgery and six months post-operatively. This retrospective study was conducted at a single institute where the clinician adhered to specific exclusion criteria, eliminating patients with lumbar disc herniation, segmental instability exceeding 4-mm translation, grade II or higher spondylolisthesis, scoliosis over 20°, infection, and previous lumbar surgeries.

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The implementation of this study was approved by the Research Ethics Review Committee of Far Eastern Memorial Hospital (No. -E). A total of 68 patients received UBE no-punch decompression surgery for DLSS between March and June of the study year.

Data regarding patient-reported outcomes were analyzed via the Wilcoxon signed-rank test, while radiological measurements were assessed using paired t-tests. A p-value below 0.05 was regarded as statistically significant. The Schizas grading system was employed to classify stenosis severity based on axial T2-weighted MRI images, with grade A indicating minimal stenosis and grade D representing the most severe collapse of the spinal canal.

The demographic, clinical, surgical, and complications data were all meticulously collected and analyzed. Each patient had a minimum of six months of post-operative follow-up, where treatment outcomes were gauged utilizing the Japanese Orthopaedic Association (JOA) score and the Oswestry Disability Index (ODI) at baseline and at 1, 3, and 6 months post-surgery.

Through this study, it was revealed that the chosen surgical technique significantly enhances patient recovery while minimizing complications. Ongoing assessment of tools such as spinal surgical osteotomes for ube showcases the growing advancements in spinal surgery methodologies aimed at improving patient outcomes and minimizing recovery times.

Achieving favorable clinical results is also intricately linked to the employment of high-grade surgical instruments, like the spinal surgery trephines protective sleeve, which contributes to the efficacy and safety of the surgical procedure.

The results of this study elucidate the positive ramifications of the “No-Punch” decompression technique within the surgical realm, suggesting it not only bolsters success rates but also encourages a swift recovery for patients suffering from DLSS.