Efficacy and Safety of Biportal Endoscopic Decompressive Laminectomy in Octogenarians With Severe Lumbar Spinal Stenosis

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Figure 1
Biportal endoscopic decompressive laminectomy in a 92-year-old woman. (A) Magnetic resonance image (MRI) showing severe central canal stenosis at the L4–L5 and L5–S1 level and moderate central canal stenosis at the L3–L4 level. (B) Postoperative MRI showed fully decompressed dura after surgery.
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Figure 2
(A and B) Changes in mean VAS score for low back and lower extremities radiating pain, ranging from 0 (no pain) to 10 (worst pain). (C) Changes in mean ODI score, ranging from 0 (no disability) to 100 (high disability). (D) Changes in mean EQ-5D value, ranging from 0 (worst quality of life) to 1.000 (best quality of life). (E) Changes in mean painDETECT score, ranging from −1 (neuropathic pain less likely) to 38 (neuropathic pain most likely). VAS, visual analog scale; ODI, Oswestry Disability Index; EQ-5D, European Quality of Life-5 Dimensions.

Table 1

Demographic and clinical patient data.

Abbreviations: ASA, American Society of Anesthesiologists; CCI, Charlson Comorbidity Index.
↵a Most severe level of operated segments.

Table 2

Clinical characteristics according to age.

Abbreviations: ASA, American Society of Anesthesiologists; CCI, Charlson Comorbidity Index.
↵a Most severe level of operated segments.

Table 3

Clinical and surgery-related outcomes for biportal endoscopy laminectomy during 12-month follow-up.

Variables	Group 1, Age≥85 y	Group 2, Age <85 y	P ^{^a}
VAS back			<0.001
Preoperation	60.92 (25.29)	52.86 (28.31)
3 mo	23.92 (23.16)	29.00 (27.96)
6 mo	27.40 (23.28)	27.59 (23.55)
12 mo	29.20 (25.22)	26.07 (25.14)
Group effect			0.720
VAS lower extremities			<0.001
Preoperation	64.92 (28.84)	58.81 (27.69)
3 mo	30.00 (27.78)	26.00 (34.20)
6 mo	32.60 (28.56)	26.90 (31.06)
12 mo	35.00 (31.64)	26.79 (33.34)
Group effect			0.612
ODI			<0.001
Preoperation	53.54 (18.00)	55.50 (13.83)
3 mo	34.25 (19.67)	41.87 (20.93)
6 mo	37.38 (18.50)	39.28 (22.30)
12 mo	36.72 (18.26)	36.50 (23.04)
Group effect			0.805
EQ-5D			<0.001
Preoperation	0.45 (0.21)	0.40 (0.19)
3 mo	0.70 (0.20)	0.65 (0.25)
6 mo	0.67 (0.21)	0.65 (0.27)
12 mo	0.69 (0.20)	0.69 (0.28)
Group effect			0.617
painDETECT			<0.001
Preoperation	14.53 (7.83)	11.93 (7.06)
3 mo	5.36 (6.46)	3.83 (4.11)
6 mo	5.15 (5.77)	5.14 (5.37)
12 mo	5.23 (5.48)	5.18 (5.31)
Group effect			0.126
Complications, n (%)^{^b}
Incidental durotomy	9 (14%)	6 (14%)	>0.99
Hematoma	4 (6%)	2 (5%)	>0.99
Surgical site infection	1 (2%)	0	>0.99
Revision surgery due to recurrence	0	1 (2%)	0.393
Delirium	4 (6%)	3 (7%)	>0.99
Pneumonia	2 (3%)	1 (2%)	>0.99
Surgery-related outcomes
Operation time, min	82.11 (30.37)	85.87 (31.70)	0.549
Hospital stay, d	5.25 (1.95)	8.16 (16.24)	0.168
Intraoperative blood loss, mL	98.14 (100.19)	131.94 (144.00)	0.182
Postoperative drainage, mL	130.92 (157.47)	142.71 (119.96)	0.694

Abbreviations: EQ-5D, European Quality of Life-5 Dimensions; ODI, Oswestry disability index; VAS, visual analog scale.
Data are presented as given as mean (SD) unless otherwise indicated.
↵a P values are from Generalized Estimating Equations: (1) Overall P values indicate the time effect over 12 months. (2) Group effect P values compare Groups 1 and 2 differences over 12 months.
↵b Fisher’s exact test was used.