Elsevier

World Neurosurgery

Volume 103, July 2017, Pages 201-209
World Neurosurgery

Original Article
Percutaneous Full Endoscopic Bilateral Lumbar Decompression of Spinal Stenosis Through Uniportal-Contralateral Approach: Techniques and Preliminary Results

https://doi.org/10.1016/j.wneu.2017.03.130Get rights and content
Under a Creative Commons license
open access

Background

When considering various risk factors such as age, comorbidities, and complications related to the surgical procedure itself, open surgery in degenerative spinal stenosis is likely to cause more complications. Here, we report the surgical procedure and preliminary clinical results of percutaneous endoscopic stenosis lumbar decompression (PESLD) technique using a uniportal-contralateral approach for bilateral decompression of degenerative spinal stenosis.

Materials and Methods

Electronic medical records of 48 consecutive patients who were treated between January 2016 and August 2016 were reviewed retrospectively. All patient received PESLD through the uniportal–contralateral approach. We analyzed the outcomes using the visual analogue scale, Macnab criteria, Oswestry Disability Index, and complication rate.

Results

There were 48 cases (15 men, 33 women). Mean age of patients was 62.44 ± 8.68 years. Mean symptom duration was 20.13 ± 16.87 months. Neurogenic intermittent claudication was 550 m on average. Follow-up period was 7.75 ± 2.28 months (range, 5–13 months). Visual analogue scale and Oswestry Disability Index decreased significantly (P < 0.001) and decreased by 1.073 and 5.795 odds ratio, respectively, in contralateral foraminotomy cases. Macnab outcome grade was good to excellent in 96% of patients. Dural tear occurred in 3 cases (6.25%), and 2 cases (4.17%) required transforaminal lumbar interbody fusion operation after this procedure.

Conclusions

The preliminary result of this uniportal–contralateral PESLD technique is encouraging (96% demonstrated a good-to-excellent outcome), and the procedure is safe. However, we need long-term follow-up and a more detailed study for more accurate results of this technique.

Key words

Bilateral decompression
Degenerative spinal stenosis
Endoscopic decompression
Percutaneous endoscopic stenosis lumbar decompression (PESLD)
Uniportal–contralateral approach

Abbreviations and Acronyms

MEDS
Microendoscopic decompression of stenosis
MIS
Minimally invasive surgery
MISS
Minimally invasive spine surgery
ODI
Oswestry Disability Index
PESLD
Percutaneous endoscopic stenosis lumbar decompression
VAS
Visual analogue scale

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Conflict of interest statement: Hyeun Sung Kim is a reference doctor for Joimax (Karlsruhe, Germany).

Supplementary digital content available online.