Outpatient Fully Endoscopic Cervical Unilateral Laminotomy for Bilateral Decompression with Virtual Postoperative Monitoring

Abstract

Objective Cervical endoscopic unilateral laminotomy for bilateral decompression (CE-ULBD) is a promising novel surgical approach. However, to date, there is a paucity of data regarding safety, efficacy, and functional outcomes following CE-ULBD. Methods The aim of this study was to investigate the outcomes of outpatient CE-ULBD combined with postoperative smartphone-based continuous physiological monitoring and virtual follow-up. Results We included a total of 23 patients in our study group. The mean age was 69.1±2.5 years. A significant postoperative reduction of the visual analogue scale for neck pain (4.1±0.6 pre- vs. 2.3±0.5 post-surgery; P<0.0001) and upper extremity pain (2.6±0.6 vs. 1.1±0.3; P=0.0012) was reported alongside a significant improvement in the Neck Disability Index (18.6±2.5 vs. 9.1±2.5; p=0.032). Eleven patients were monitored with continuous physiological monitoring via a smartphone app (SPINEhealthie). Those patients were more likely to be outpatients (p=0.0002) and less likely to have postoperative inpatient clinic utilization (p<0.0001). Continuous physiological monitoring suggested a trend towards higher levels of function in patients following CE-ULBD. Conclusion Our early results suggest that outpatient CE-ULBD followed by virtual postoperative monitoring is a safe and efficient therapeutic intervention for symptomatic cervical spinal stenosis.

Keywords

• endoscopic
• laminotomy
• telemedicine