ORIGINAL ARTICLE
Using a percutaneous spinal endoscopy unilateral posterior interlaminar approach to perform bilateral decompression for patients with lumbar lateral recess stenosis

https://doi.org/10.1016/j.asjsur.2019.08.010Get rights and content
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Highlights

  • A novel percutaneous endoscopic unilateral approach decompression technique was introduced in patients with bilateral LLRS.

  • The efficacy and safety of this full-endoscopic decompression procedure were evaluated.

  • Key points of percutaneous spinal endoscopic bilateral decompression via unilateral approach were detailed.

Summary

Objective

To report the clinical and radiographic outcomes of 47 patients with bilateral symptomatic lumbar lateral recess stenosis (LLRS) treated with percutaneous spinal endoscopy (PSE) via a unilateral posterior interlaminar approach with bilateral decompression.

Methods

Forty-seven patients with single-level LLRS and bilateral symptoms who underwent PSE using a unilateral posterior interlaminar approach to perform bilateral decompression between May 2014 and June 2016 were reviewed retrospectively. Surgical-related data were collected, and clinical efficacy was evaluated using the Visual Analogue Scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and the single continuous walking distance (SCWD) without pain at preoperative and postoperative time points. Patient satisfaction was evaluated by modified MacNab criteria at the one-year postoperative time point.

Results

All patients displayed improvements in clinical symptoms after surgery and were discharged the day of surgery. The mean operation time and blood loss were 91.17 ± 16.81 min and 13.53 ± 4.94 mL, respectively. At a mean follow-up of 18.33 ± 4.16 months, none of the patients required reoperation, while 6 of 47 patients experienced complications. VAS scores for back and leg pain, ODI, and SCWD were significantly improved at all postoperative time points compared with the preoperative values. Satisfactory (excellent or good) results were demonstrated in 44 of 47 patients (93.6%) at the one-year postoperative time point.

Conclusions

The percutaneous spinal endoscopic technique via a unilateral posterior interlaminar approach for performing bilateral decompression is a less invasive, effective and safe surgery and can be considered an alternative option for treating patients with bilateral symptomatic LLRS.

Keywords

Percutaneous spinal endoscopy
Lumbar lateral recess stenosis
Unilateral posterior interlaminar approach
Bilateral decompression
Minimally invasive spinal surgery

Abbreviations

LLRS
Lumbar lateral recess stenosis
PSE
Percutaneous spinal endoscopy
PSED
Percutaneous spinal endoscopic decompression
MISS
Minimally invasive spinal surgery
MR
Magnetic resonance
CT
Computed tomography
VAS
Visual analogue scale
B-VAS
Visual analogue scale of back pain
L-VAS
Visual analogue scale of leg pain
ODI
Oswestry Disability Index
SCWD
Single continuous walking distance without pain
SVHM
Spinal venous hypertensive myelopathy

Cited by (0)

1

Zhijun Xin is the first author.

2

Peng Huang is the co-first authors.