Bilateral operation of lumbar degenerative central spinal stenosis in full-endoscopic interlaminar technique with unilateral approach: prospective 2-year results of 74 patients

J Spinal Disord Tech. 2011 Jul;24(5):281-7. doi: 10.1097/BSD.0b013e3181f9f55e.

Abstract

Study design: Prospective study of the patients with degenerative spinal central stenosis, operated bilateral in a full-endoscopic unilateral technique.

Objective: The objective of this prospective study was to examine the technical possibilities of full-endoscopic interlaminar bilateral technique with unilateral approach in degenerative lumbar central spinal stenosis and predominant leg symptoms using new designed endoscopes and instruments.

Summary of background data: Extensive decompression with laminectomy where appropriate, is often still described as the method of choice in the operation of degenerative lumbar spinal stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the advantages they offer in surgical technique and in rehabilitation. At the spine, 1 essential point was the developing of the instruments for sufficient bone resection under continuous visual control. This enabled the use in the operation of spinal canal stenoses.

Methods: A total of 72 patients with lumbar central spinal stenosis full-endoscopic unilateral decompression were followed for 2 years. In addition to general and specific parameters, these measuring instruments were used: VAS, German version North American Spine Society Instrument, Oswestry Low-back Pain Disability Questionnaire.

Results: The results show that 70.8% no longer have leg pain or it was nearly completely reduced and 22.2% have occasional pain. The decompression results were equal to those of conventional procedures. The complication rate was low. The full-endoscopic techniques brought advantages in these areas: operation, complications, traumatization, and rehabilitation.

Conclusions: The recorded results show that the full-endoscopic interlaminar bilateral decompression with unilateral approach is a sufficient and safe supplement and alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopy / instrumentation
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Degeneration / diagnostic imaging
  • Intervertebral Disc Degeneration / pathology
  • Intervertebral Disc Degeneration / surgery*
  • Laminectomy / instrumentation
  • Laminectomy / methods
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Neurosurgical Procedures / instrumentation
  • Neurosurgical Procedures / methods*
  • Prospective Studies
  • Radiography
  • Spinal Stenosis / diagnostic imaging
  • Spinal Stenosis / pathology
  • Spinal Stenosis / surgery*
  • Spondylosis / diagnostic imaging
  • Spondylosis / pathology
  • Spondylosis / surgery*
  • Treatment Outcome