Objective:

To analyze the effects of limaprost combined with unilateral biportal endoscopic (UBE) surgery on patients with lumbar spinal stenosis (LSS) at different time points and in various patient populations.

Approach:

• Study Design: A retrospective study involving patients with LSS who underwent UBE surgery, divided into intervention (limaprost + UBE) and control (UBE alone) groups.
• Outcome Measures: Evaluated using Visual Analog Scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score, modified MacNab criteria, Manual Muscle Testing (MMT), cross-sectional area (CSA), and anteroposterior diameter of the spinal canal.
• Statistical Analysis: Utilized generalized estimating equation (GEE) model and multiple linear regression to assess treatment effects.

Key Findings:

• The intervention group showed significantly better results in VAS, ODI, JOA, MMT, and modified MacNab scores compared to the control group.
• No significant improvement was observed in CSA or the anteroposterior diameter of the spinal canal.
• The intervention had a stronger effect on pain relief at 1 month and neurological function recovery at 3 months postoperatively.
• Subgroup analysis indicated that patients aged ≥65 years, with BMI < 25, and with central-type stenosis were more suitable for the combined treatment.

Interpretation:

The combined application of limaprost and UBE surgery was associated with better clinical outcomes in pain reduction and neurological recovery for LSS patients.

Limitations:

• Retrospective design may introduce selection bias.
• Limited generalizability due to a specific patient population.

Conclusion:

The findings suggest that limaprost combined with UBE surgery may improve clinical outcomes in LSS patients, particularly regarding pain and neurological recovery.