Ambulatory Uniportal Interlaminar Endoscopic Approach for Symptomatic Adjacent Segment Disease after Lumbar Fusion in Aged Patients

Background: There is no consensus on treating symptomatic adjacent segment disease (ASD). The best choice depends on several factors. Spinal fusion is associated with complications that may be more relevant in adult patients. The study aimed to report the feasibility and clinical results obtained in patients over 60 years of age with ASD treated with a uniportal interlaminar endoscopic approach. Materials and Methods: We retrospectively reviewed patients> 60 years old admitted with radicular symptoms secondary to ASD history between May 2020 and January 2023 who underwent endoscopic surgery using a uniportal interlaminar approach. We collected information on patient-reported outcome measures (PROMs), including pre-and postoperative visual analog scale index (VAS), Oswestry ODI criteria, and patient satisfaction score using the MacNab criteria. Results: Eight patients, five women and three men, with an average age of 72.8 ± 7.89 years, were included in the study. The average follow-up time was 23.0 ± 16.7 months. The difference between the preoperative and postoperative VAS and ODI was statistically significant. Satisfaction with the procedure was above 80%, and the results were excellent. There were no intraoperative complications; only one case had to be reoperated with a conventional technique. No patient had a hospital stay. Conclusion: Ambulatory uniportal interlaminar endoscopic surgery is a technique that may become an alternative for the treatment of symptomatic ASD in patients over 65 years of age.