Minimally Invasive Endoscopic Bilateral Decompression with a Unilateral Approach (endo-BiDUA) for Elderly Patients with Lumbar Spinal Canal Stenosis

Wada, Kanichiro; Sairyo, Koichi; Sakai, Toshinori; Yasui, N

doi:10.1055/s-0030-1247559

Cited by 27 publications

(41 citation statements)

References 17 publications

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“…[5] Wada et al also reported improvement in the mean Japanese Orthopaedic Association (JOA) score from 17.0 before operation to 23.3 after surgery. [7] The clinical results were excellent in Xu et al series with 65.6% and 34.4% patients had excellent and good pain relief respectively according to the Macnab scale. [6] Endoscopic technique can be as effectively as an open technique with the additional benefit of decreased complications and morbidity.…”

Section: Results Of Surgerymentioning

confidence: 83%

“…Such procedures should be done after achieving sufficient experience to decrease complications. [7,8,16] Part of the offending disc is removed.…”

Section: Methodsmentioning

confidence: 99%

“…Endoscopic technique can be used effectively in LCS and lateral recess stenosis. [7][8][9][10] Endoscopic technique can be used to decompress the entire length of the nerve root from the spinal canal to the extraforaminal zone while preserving the posterior elements in foraminal stenosis. [11] Bilateral severe bony canal stenosis and unstable spine are contraindications for endoscopic decompression in LCS.…”

Section: Indications Of Surgerymentioning

confidence: 99%

“…[1][2][3] Although the role of surgery using minimally invasive techniques in lumbar disc remains unclear in the Cochrane review, [4] there are reports of good results of endoscopic decompression in LCS. [5][6][7] Bilateral decompression through unilateral fenestration can be performed for lumbar spinal stenosis with good clinical results. [6] Bilateral decompression with a unilateral approach can increase the area of the dural tube up to 408.0% (range: 211-774%).…”

Section: Introductionmentioning

confidence: 99%

“…[6] Bilateral decompression with a unilateral approach can increase the area of the dural tube up to 408.0% (range: 211-774%). [7] Better visualization of the lesion, reduced morbidity, short hospital stay and ultimately lower cost are some of the advantages of endoscopic technique over the…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic posterior decompression of lumbar canal stenosis

Yadav

Parihar²,

Kher³

et al. 2013

IJNS

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Lumbar canal stenosis (LCS) is quite common. Surgery is indicated when patient fails to improve after conservative treatment. Endoscopic technique can be used in LCS and lateral recess stenosis. It can be performed in degenerative canal stenosis or with disc bulges. Bilateral severe bony canal stenosis and unstable spine are the contraindications. This procedure should be avoided in patients with a history of trauma. Detailed history and thorough physical examination should be performed to find out exact level of pathology responsible for symptoms. Patient’s symptoms must correlate with radiological findings. Magnetic resonance imaging is the investigation of choice because of its superior visualization of soft-tissue. Computed tomography scan does give a more accurate and detailed picture of the bony anatomy. Although the operative time and the complication rate could be more in the initial learning curve, the results of endoscopic decompression are comparable with conventional open procedures with the additional benefit of decreased complications and lower morbidity, when sufficient experience is gained. Complications in endoscopic surgery for LCS could be dural tears, hematomas and root and facet injury. This procedure is also associated with limitations such as steep learning curve and the contra lateral decompression may not be as good as ipsilateral side. Some of the limitations of this technique can be overcome by attending live operative workshop, practice on models and hands on cadaveric dissection. Conversion to an open procedure may be required when there is disorientation, management of dural tear and for control of bleeding.

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Section: Results Of Surgerymentioning

confidence: 83%

“…Such procedures should be done after achieving sufficient experience to decrease complications. [7,8,16] Part of the offending disc is removed.…”

Section: Methodsmentioning

confidence: 99%