{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:46:14Z","timestamp":1790700374462,"version":"4.1.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to compare the outcomes of unilateral biportal endoscopy, unilateral laminectomy bilateral decompression (UBE-ULBD), and open lumbar decompression (OLD) in patients with lumbar epidural lipomatosis (LEL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational study was conducted from March 2019 to May 2022 and encompassed 33 patients with LEL who underwent lumbar decompression. The study included 15 cases of UBE-ULBD decompression and 18 cases of open decompression, which were followed up for 1 year. The baseline characteristics, initial clinical manifestations, and surgical details [including estimated blood loss (EBL) and preoperative complications] of all patients were recorded. Radiographic evaluation included the cross-sectional area (CSA) of the thecal sac and paraspinal muscles on MRI. Clinical results were analyzed using the Short Form-36 Score (SF-36), the Numeric Pain Rating Scale (NRS) for lumbar and leg pain, creatine kinase, the Roland and Morris Disability Questionnaire (RMDQ), and the Oswestry Disability Index (ODI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The dural sac CSA increased considerably at the 1-year postoperative follow-up in both groups (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). The operative duration in the OLD group (48.2 \u00b1 7.2 min) was shorter than that in the UBE-ULBD group (67.7 \u00b1 6.3 min, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). The OLD group (97.2 \u00b1 19.8 mL) was associated with more EBL than the UBE-ULBD group (40.6 \u00b1 13.6 mL, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). The duration of hospitalization in the OLD group (5.4 \u00b1 1.3 days) was significantly longer compared with the UBE-ULBD group (3.5 \u00b1 1.2 days, <jats:italic>p<\/jats:italic> &amp;lt; 0.01). The SF-36, NRS, RMDQ, and ODI scores improved in both groups postoperatively (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). Serum creatine kinase values in the UBE-ULBD group (101.7 \u00b1 15.5) were significantly lower than those in the OLD group (330.8 \u00b1 28.1 U\/L) 1 day after surgery (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). The degree of paraspinal muscle atrophy in the UBE-ULBD group (4.81 \u00b1 1.94) was significantly lower than that in the OLD group (12.15 \u00b1 6.99) at 1 year (<jats:italic>p<\/jats:italic> &amp;lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>UBE-ULBD and OLD demonstrated comparable clinical outcomes in treating LEL. However, UBE-ULBD surgery was associated with shorter hospital stays, lower rates of incision infection, lighter paravertebral muscle injury, and lower EBL than OLD surgery. Consequently, UBE-ULBD can be recommended in patients with LEL if conservative treatment fails.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1366357","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T04:29:17Z","timestamp":1713932957000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Unilateral biportal endoscopy vs. open decompression for lumbar epidural lipomatosis-cohort study using a prospective registry"],"prefix":"10.3389","volume":"15","author":[{"given":"Bing","family":"Tan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-hao","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-yuan","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-bo","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuo-hua","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-Yuan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e250112","DOI":"10.1136\/bcr-2022-250112","article-title":"Spinal epidural lipomatosis and focal posterior longitudinal ligament hypertrophy causing severe cauda equina crowding","volume":"15","author":"Hadidi","year":"2022","journal-title":"BMJ Case Rep."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1007\/s00586-018-5584-2","article-title":"Lumbar epidural lipomatosis is associated with visceral fat and metabolic disorders","volume":"27","author":"Morishita","year":"2018","journal-title":"Eur Spine J."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e25212","DOI":"10.7759\/cureus.25212","article-title":"Acute spinal cord injury due to epidural lipomatosis without osseous injury","volume":"14","author":"Mugge","year":"2022","journal-title":"Cureus."},{"key":"B4","doi-asserted-by":"publisher","first-page":"322","DOI":"10.3390\/diagnostics13020322","article-title":"Could spinal epidural lipomatosis be the hallmark of metabolic syndrome on the spine? 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