Features of Surgical Treatment of Lumbar Foraminal Stenosis

Summary. Minimally invasive spine surgery is currently undergoing rapid development. New techniques for the treatment of degenerative-dystrophic diseases of the spine have been introduced; however, long-term treatment outcomes remain insufficiently studied. The use of unilateral biportal endoscopy in Ukraine is still limited, which makes research in this field particularly relevant. Objective. This study aimed to analyze the outcomes of treatment and complications after unilateral biportal endoscopic decompression in patients with lumbar foraminal stenosis. Materials and Methods. The study was conducted at the Endoclinic Medical Center in Rivne from January to July 2024. The study cohort consisted of 50 patients. All patients underwent unilateral biportal endoscopic decompression of the intervertebral foramen at the following levels: L3–L4 (n=1), L4–L5 (n=19), and L5–S1 (n=30). Results. The results of our study showed that pain intensity according to the Visual Analog Scale (VAS) significantly decreased during the observation period. The preoperative score was 7.05±0.76 for the lumbar spine and 7.15±0.81 for the lower limb; on the second postoperative day, VAS scores decreased to 3.75±0.85 and 3.85±0.93, respectively. At 3 and 6 months after surgery, lower back pain intensity decreased to 1.75±0.85 and 1.65±0.87; a similar trend was observed for pain in the lower limbs (1.75±0.85 and 1.6±0.99). These results indicate a significant positive dynamics at all stages of follow-up. The Oswestry Disability Index (ODI) was 62.5±6.38% preoperatively and decreased to 21.7±4.21% one month after surgery; at 3 months it was 14±5.39% and 12.1±6.17% at 6 months of follow-up. Overall, excellent or good clinical outcomes were achieved in 84% of cases. Conclusions. Unilateral biportal endoscopic decompression is an effective method for the treatment of lumbar foraminal stenosis. Compared with open surgical procedures, this technique offers a number of advantages.