Asian Spine J.  2019 Apr;13(2):272-282. 10.31616/asj.2018.0228.

Therapeutic Feasibility of Full Endoscopic Decompression in One- to Three-Level Lumbar Canal Stenosis via a Single Skin Port Using a New Endoscopic System, Percutaneous Stenoscopic Lumbar Decompression

• Lim KT
• Nam HG
• Kim SB
• Kim HS
• Park JS
• Park CK

• KMID: 2447534
• DOI: http://doi.org/10.31616/asj.2018.0228

Abstract

STUDY DESIGN: This retrospective study involved 450 consecutive cases of degenerative lumbar stenosis treated with percutaneous stenoscopic lumbar decompression (PSLD). PURPOSE: We determined the feasibility of PSLD for lumbar stenosis at single and multiple levels (minimum 1-year follow-up) by image analysis to observe postoperative widening of the vertebral canal in the area. OVERVIEW OF LITERATURE: The decision not to perform an endoscopic decompression might be due to the surgeon being uncomfortable with conventional microscopic decompression or unfamiliar with endoscopic techniques or the unavailability of relevant surgical tools to completely decompress the spinal stenosis.
METHODS
The decompressed canal was compared between preoperative controls and postoperative treated cases. Data on operative results, including length of stay, operative time, and surgical complications, were analyzed. Patients were assessed clinically on the basis of the Visual Analog Scale (VAS) score for the back and legs and using the Oswestry Disability Index (ODI).
RESULTS
Postoperative magnetic resonance imaging revealed that PSLD increased the canal cross-sectional area by 52.0% compared with the preoperative area at the index segment (p<0.001) and demonstrated minimal damage to the normal soft tissues including muscles and the extent of removed normal bony tissues. Mean improvements in VAS score and ODI were 4.0 (p<0.001) and 40% (p<0.001), respectively.
CONCLUSIONS
PSLD could be an alternative to microscopic or microendoscopic decompression with various advantages in the surgical management of lumbar stenosis.

Keyword

Spinal stenosis; Percutanous stenoscopic lumbar decompression; Minimally invasive spine surgery; Decompression

MeSH Terms

Constriction, Pathologic*
Decompression*
Humans
Leg
Length of Stay
Magnetic Resonance Imaging
Muscles
Operative Time
Retrospective Studies
Skin*
Spinal Stenosis
Visual Analog Scale