Clinical outcomes of MED and iLESSYS^® Delta for the treatment of lumbar central spinal stenosis and lateral recess stenosis: A comparison study

Abstract

Microendoscopic discectomy (MED) is an established procedure used to treat lumbar central spinal stenosis (LCSS) and lateral recess stenosis (LRS). The Interlaminar Endoscopic Surgical System iLESSYS ® Delta approach has been developed from the traditional interlaminar endoscopic technique for the treatment of LCSS and LRS. In the present study, MED was used as a reference to evaluate this newly developed approach. A total of 82 and 52 patients with radicular leg pain and/or neurogenic claudication symptoms were treated by spinal canal decompression using the MED or iLESSYS ® Delta approach, respectively. The clinical outcomes of the patients were analyzed using the Modified MacNab's criteria, visual analogue scale (VAS) leg pain score, VAS back pain score and the Oswestry Disability Index (ODI) score. Finally, the effectiveness of the decompression was evaluated on a cross-sectional area of the dural sac (CSAD) at the disc level. The incision length in the iLESSYS ® Delta group was significantly decreased compared with the MED group (P<0.05); however, the duration of the operation in the iLESSYS ® Delta group was significantly longer compared with the MED group (P<0.05). The VAS score of the back and ODI score in the iLESSYS ® Delta group were significantly decreased compared with the MED group at the 1-week follow-up (P<0.0125). The postoperative CSAD was also significantly increased in both groups compared with before the operation (P<0.05); however, there were no significant differences in the postoperative CSAD between the two groups. The good-to-excellent rates of the MED and iLESSYS ® Delta approach were 89.0 and 90.4%, respectively, whereas the complication rates of the MED and iLESSYS ® Delta system were 3.66 and 3.85% in the two groups, respectively. In conclusion, the iLESSYS ® Delta approach was identified to be comparable with the MED approach for treating LCSS and LRS, demonstrating both precise and limited decompression. In addition, the iLESSYS ® Delta approach may reduce the short-term back pain and promote faster recovery compared with the MED.

Percutaneous spinal endoscopy with unilateral interlaminar approach to perform bilateral decompression for central lumbar spinal stenosis: radiographic and clinical assessment

“…At the same time, we noticed that the big working channel endoscopes techniques such as iLESSYS® Delta system [ 45 ] are also appropriate surgical methods for the treatment of central lumbar spinal stenosis, which are equipped with a larger size working cannula and endoscopic instruments, and permits big osteophytes or soft tissues to be removed without extra maneuvers under good endoscopic visualization [ 46 , 47 ], and the operation time is also shorter than our technology, but in order to broader endoscopic field of view, it also caused more damage to the tissue. However, The decompression of our spinal endoscopy is more accurate, and less damage to tissue, but the operation is difficult and the learning curve is steep, Comparing the two surgical techniques, we think that each operation has its own advantages, we can be more rational in the choice of surgical indications.…”

Comparison of the short-term effects of lumbar endoscopic and microscopic tubular unilateral laminotomy with bilateral decompression in the treatment of elderly patients with lumbar spinal stenosis

“…Observation group [ 10 ]: After successful general anesthesia, the patient was fixed on the operating table in a prone position with the chest and iliac bone partially elevated and the target vertebral space positioned on the body surface. The skin was routinely disinfected and covered with sterile cavity wipes.…”

Microendoscopic Lumbar Posterior Decompression Surgery for Lumbar Spinal Stenosis: Literature Review

“…There are two types of surgery in this category: uniportal full-endoscopic surgery using the endoscope, which includes a working channel in the scope system, and biportal endoscopic surgery with two different skin incisions for the endoscope and for inserting instruments as in arthroscopic knee surgery. Wu et al [ 52 ] compared the clinical outcomes of microendoscopic decompression and uniportal full-endoscopic decompression and reported that the operating time was shorter, but skin incision was longer, for microendoscopic decompression. Improvements in VAS scores for leg pain were similar in the two groups.…”