PT  - JOURNAL ARTICLE
AU  - Carolina Ramírez Martínez
AU  - Kai Uwe Lewandrowski
AU  - José Gabriel Rugeles Ortíz
AU  - Gabriel Oswaldo Alonso Cuéllar
AU  - Jorge Felipe Ramírez León
TI  - Transforaminal Endoscopic Discectomy Combined With an Interspinous Process Distraction System for Spinal Stenosis
AID  - 10.14444/7121
DP  - 2020 Oct 01
TA  - International Journal of Spine Surgery
PG  - 7121
4099  - http://ijssurgery.com//content/early/2020/10/27/7121.short
4100  - http://ijssurgery.com//content/early/2020/10/27/7121.full
AB  - Background The combination of the percutaneous transforaminal endoscopic decompression (PTED) with an interspinous process distraction system (IPS) may offer additional benefit in the treatment of spinal stenosis in patients who have failed nonsurgical treatment.Methods We retrospectively reviewed the medical records of 33 patients diagnosed with lumbar stenosis and radiculopathy and treated them with transforaminal endoscopic lumbar decompression between 2013 and 2017. Primary outcome measures were modified Macnab as well as preoperative and postoperative visual analog scale (VAS) criteria and the Oswestry Disability Index (ODI). Only patients with a minimum follow-up of 2 years were included.Results A total of 28 patients were treated with a combination of PTED and percutaneous IPS (group A), and 5 patients were treated with PTED and mini–open IPS (group B). In group A patients, there was a 4.48 reduction in the VAS score. The ODI changed from 50.25 preoperatively to 18.2 postoperatively, and excellent and good Macnab outcomes were obtained in 78% of patients. In group B patients, the mean VAS reduction was 5.2 points. The ODI changed from 44.34 preoperatively to 14.62 postoperatively, and 80% of group B patients achieved excellent and good Macnab outcomes. No complications related to PTED or IPS were observed throughout the 2-year follow-up.Conclusions The addition of IPS to the PTED procedure in select patients may offer additional benefits to patients being treated for lumbar lateral stenosis and foraminal stenosis with low-grade spondylolisthesis.Level of Evidence 3.Clinical Relevance Feasibility study.