Korean J Spine.  2009 Jun;6(2):61-67.

Efficacy of Microdecompression with Microscope and Tubular Retractor in Lumbar Foraminal Stenosis: Surgical Technique and Clinical Outcomes

• Choi HM
• Park KH
• Kim TW
• Chi MP
• Kim JO
• Kim JC

Abstract

OBJECTIVE
The objective of this study is to evaluate the efficacy of microdecompression (MD) with microscope and tubular retractor in lumbar foraminal stenosis (FS) and to analyze the clinical outcomes.
METHODS
From January 2006 to December 2007, 22 patients with symptomatic lumbar FS underwent conventional decompressive surgery (CDS) and MD was performed in other 20 patients. Clinical outcome was measured using a Visual Analogue Scale (VAS) and Macnab?fs criteria. Spinal instability was determined by radiologic assessment of flexion-extension radiographs.
RESULTS
The CDS group included 14 men and 8 women. The MD group included 14 men and 6 women. The mean age was 66.2 years (range, 46-80 yrs) in the CDS group and 65.4 years (range, 59-74 yrs) in the MD group. Average follow-up periods were 18.6 months in the CDS group and 16.5 months in the MD group. Mean operating time was 126 minutes in the CDS group and 168 minutes in the MD group. The mean VAS of back pain decreased from 2.68 to 1.36 in the CDS group and from 2.85 to 1.25 in the MD group. The mean VAS score of leg pain decrea- sed from 6.68 to 1.48 in the CDS group and from 6.65 to 1.40 in the MD group. The success rate of CDS group was 86.3 % (19/22), compared with 85.0% (17/20) for MD group. Radiologically, there was no spinal instability.
CONCLUSION
MD could achieve neural decompression and offer an effective treatment of lumbar FS. However it was a technically demanding procedure and effective in limited operative indications. We need to consider long-term follow-up.

Keyword

Lumbar; Foraminal Stenosis; Open decompressive surgery; Tubular retractor; Microdecom

MeSH Terms

Back Pain
Constriction, Pathologic
Decompression
Female
Follow-Up Studies
Humans
Leg
Male