Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (3): 1-7.doi: 10.6040/j.issn.1671-7554.0.2024.1169

• Clinical Diagnosis and Treatment in Orthopedics •    

Clinical analysis of one-hole split endoscope for lumbar spinal stenosis based on enhanced recovery after surgery

HU Bingtao1, ZHANG Wencan1, WANG Chongyi1, LIN Xiangyu1, WANG Kaibin1, FENG Yunze1, LIU Chen, XU Wanlong1, LI Le1, SI Haipeng1,2   

  1. 1. Department of Orthopedics, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Orthopedics, Qilu Hospital of Shandong University(Qingdao), Qingdao 266000, Shandong, China
  • Published:2025-04-08

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Abstract: Objective To investigate the clinical efficacy of the one-hole split endoscope(OSE)treatment protocol under the enhanced recovery after surgery(ERAS)concept for treating lumbar spinal stenosis(LSS). Methods A retrospective analysis was conducted on 130 LSS patients treated at Qilu Hospital of Shandong University between January 2020 and December 2023. There were 71 males and 59 females, aged 23 to 77 years, with a mean age of(54.42±11.82)years. Patients were divided into the following two groups based on whether the ERAS concept was followed during their treatment. The ERAS group(n=65)received the OSE treatment under the ERAS concept, while the non-ERAS group(n=65)underwent the traditional interlaminar fenestration surgery without the ERAS concept. Key outcomes, including hospitalization duration, operation time, estimated blood loss, complication incidence, visual analog scale(VAS)for low back and leg pain, Oswestry disability index(ODI), Japanese Orthopaedic Association scores(JOA), and modified MacNab efficacy evaluation criteria(MacNab), were compared between the two groups. Results The ERAS group showed significantly better VAS, ODI, and JOA scores than the non-ERAS group at two days after the operation(P<0.05). However, at 3 months after the operation, there were no significant differences between the two groups in VAS, ODI, JOA scores, and modified MacNab criteria(P>0.05). The average operation time in the ERAS group was longer than in that the non-ERAS group, whereas the average estimated blood loss and hospitalization duration were significantly shorter than those in the non-ERAS group(P<0.05). No patients in either group required readmission before the end of the follow-up period. Additionally, postoperative complications were observed in three patients in the non-ERAS group, compared to only one patient in the ERAS group. Conclusion The combination of OSE surgery and ERAS concept in LSS treatment promotes rapid postoperative recovery. Consequently, the endoscopic surgical treatment under the ERAS concept could be considered an effective alternative strategy for LSS treatment.

Key words: Enhanced recovery after surgery, One-hole split endoscope, Lumbar spinal stenosis, Minimally invasive technique

CLC Number: 

  • R681.5
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