Minimally invasive spinal decompression for degenerative lumbar spondylolisthesis and stenosis maintains stability and may avoid the need for fusion

Minamide, Akihito; Yoshida, Munehito; Simpson, Andrew K.; Nakagawa, Yukihiro; Iwasaki, Hiroshi; Tsutsui, Shunji; Takami, Masanari; Hashizume, Hiroshi; Yukawa, Yasutsugu; Yamada, Hiroshi

doi:10.1302/0301-620x.100b4.bjj-2017-0917.r1

Cited by 46 publications

(62 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, spondylolisthesis has been indicated to rarely progress in adults (22). Recent studies have demonstrated that the additional fusion may not yield obvious clinical improvements over decompression alone, particularly when minimally invasive decompression is used (1,9). The extent of resection of the articular joint or ligamentous elements exhibits a strong influence on the degree of spinal instability (23).…”

Section: Discussionmentioning

confidence: 99%

“…Minimally invasive decompression, which involves a small incision, causes significantly less tissue disruption than open surgery and provides greater patient satisfaction, and is increasingly and more frequently used for DLS (8). Certain studies have indicated that microendoscopic laminotomy is also an effective procedure for the treatment of patients with DLS (8,9). Minimally invasive decompression may prevent post-operative instability and lead to the preservation of stabilizing structures, avoiding the requirement for fusion.…”

Section: Efficacy Of Percutaneous Transforaminal Endoscopic Decompresmentioning

confidence: 99%

“…Minimally invasive decompression may prevent post-operative instability and lead to the preservation of stabilizing structures, avoiding the requirement for fusion. Therefore, minimally invasive decompression procedures have been attracting attention in cases of radiating pain-dominant DLS that is associated with spinal stenosis without severe segmental instability (9).…”

Section: Efficacy Of Percutaneous Transforaminal Endoscopic Decompresmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of percutaneous transforaminal endoscopic decompression treatment for degenerative lumbar spondylolisthesis with spinal stenosis in elderly patients

Jin

et al. 2019

Exp Ther Med

View full text Add to dashboard Cite

The efficacy of fusion combined with decompression for the treatment of spinal stenosis with degenerative lumbar spondylolisthesis (DLS) has been debated. Percutaneous transforaminal endoscopic decompression (PTED) under local anesthesia is an ultra-minimally invasive procedure. The present study aimed to evaluate whether PTED is an effective alternative therapy for spinal stenosis associated with DLS in elderly patients. PTED was performed in elderly patients exhibiting lumbar stenosis and low-grade (Meyerding grades I and II) DLS; these patients also exhibited leg-dominant symptoms and had tolerable or absent mechanical back pain. Administration of general anesthesia may be considerably hazardous in patients when combined with comorbid conditions that result from aging. Therefore, the present procedure was performed under local anesthesia. No obvious radiographic lumbar intervertebral instability was identified prior to surgery. Pre-and post-operative visual analogue scale (VAS) score, Oswestry Disability Index (ODI) and walking distance data were collected. The clinical global outcomes following surgery were evaluated using modified MacNab criteria. A total of 18 elderly patients underwent surgery using PTED techniques. The mean follow-up time was 27.7 months (range, 24-33 months) and the mean estimated blood loss was 18.33 ml (range, 10-35 ml). The mean pre-operative ODI, VAS score of the back and VAS score of the leg were 68.2±6.5, 2.8±1.4 and 6.6±1.2, respectively. All average scores improved post-operatively to 31.7±5.2, 1.5±0.6 and 1.7±0.8, respectively, at the latest follow-up. A statistically significant improvement was observed for all scores at 1 month and that the scores remained relatively stable after that. According to modified MacNab criteria, the good-to-excellent rate was 83.3%. Only 1 patient required micro-decompression surgery due to poor rating. The present study indicated that PTED may be an effective alternative therapeutic option for elderly patients with low-grade DLS associated with spinal stenosis. However, PTED techniques continue to evolve and further follow-up studies are required to determine the long-term outcomes of this treatment technique.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Efficacy Of Percutaneous Transforaminal Endoscopic Decompresmentioning

confidence: 99%

Section: Efficacy Of Percutaneous Transforaminal Endoscopic Decompresmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of percutaneous transforaminal endoscopic decompression treatment for degenerative lumbar spondylolisthesis with spinal stenosis in elderly patients

Jin

et al. 2019

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…While lumbar spinal stenosis can be congenital [2], the most common cause of lumbar spinal stenosis is degenerative spondylosis [3], which commonly affects the elderly population. In fact, lumbar spinal stenosis is a leading cause of disability in the elderly [4][5][6][7][8][9][10][11][12] with reported rates as high as 11.2% in the 70-80-year-old population. Moreover, lumbar spinal stenosis poses a significant socioeconomic burden to patients and was associated with $1.65 billion in Medicare costs in 2009 [13].…”

Section: Introductionmentioning

confidence: 99%

Decompression Surgery versus Interspinous Devices for Lumbar Spinal Stenosis: A Systematic Review of the Literature

et al. 2020

View full text Add to dashboard Cite

In this retrospective review study, the authors systematically reviewed the literature to elucidate the efficacy and complications associated with decompression and interspinous devices (ISDs) used in surgeries for lumbar spinal stenosis (LSS). LSS is a debilitating condition that affects the lumbar spinal cord and spinal nerve roots. However, a comprehensive report on the relative efficacy and complication rate of ISDs as they compare to traditional decompression procedures is currently lacking. The PubMed database was queried to identify clinical studies that exclusively investigated decompression, those that exclusively investigated ISDs, and those that compared decompression with ISDs. Only prospective cohort studies, case series, and randomized controlled trials that evaluated outcomes using the Visual Analog Scale (VAS), Oswestry Disability Index, or Japanese Orthopedic Association scores were included. A random-effects model was established to assess the difference between preoperative and the 1–2-year postoperative VAS scores between ISD surgery and lumbar decompression. This study included 40 papers that matched our criteria. Twenty-five decompression-exclusive clinical trials with 3,386 patients and a mean age of 68.7 years (range, 31–88 years) reported a 2.2% incidence rate of dural tears and a 2.6% incidence rate of postoperative infections. Eight ISD-exclusive clinical trials with 1,496 patients and a mean age of 65.1 (range, 19–89 years) reported a 5.3% incidence rate of postoperative leg pain and a 3.7% incidence rate of spinous process fractures. Seven studies that compared ISDs and decompression in 624 patients found a reoperation rate of 8.3% in ISD patients vs. 3.9% in decompression patients; they also reported dural tears in 0.32% of ISD patients vs. 5.2% in decompression patients. A meta-analysis of the randomized controlled trials found that the differences in preoperative and postoperative VAS scores between the two groups were not significant. Both decompression and ISD interventions are unique surgical interventions with different therapeutic efficacies and complications. The collected studies do not consistently demonstrate superiority of either procedure over the other but understanding the differences between the two techniques can help tailor treatment regimens for patients with LSS.

show abstract

“…Surgical approaches generally include anterior and posterior approaches. Different surgical methods and approaches should be selected according to individual conditions [6]. However, traditional surgery may lead to injury to the adjacent vital organs, muscle detachment and excessive resection of the facet joints.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of posterior percutaneous full-endoscopic cervical foraminotomy for cervical osseous foraminal stenosis

Zhang¹,

Du²,

Ao³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background To evaluate the efficacy of posterior percutaneous full-endoscopic cervical foraminotomy for cervical osseous foraminal stenosis. Methods During October 2015 to October 2018, 30 patients with skeletal cervical canal stenosis who met the selection criteria were included in the study. All patients underwent percutaneous posterior full-endoscopic nerve root canal decompression. Pain visual analogue scale (VAS) and cervical dysfunction index (NDI) were used to assess the degree of pain relief. Results All patients were followed up for 2 days to 12 months, and the final follow-up was also significantly improved after surgery, and the difference was statistically significant (P <0.05). At the last follow-up, the clinical efficacy was evaluated using the modified Macnab criteria. Conclusion Percutaneous posterior total endoscopic nerve canal incision can successfully complete the decompression of osseous neck canal stenosis. It can be used as a treatment option for patients with bony stenosis.

show abstract

Minimally invasive spinal decompression for degenerative lumbar spondylolisthesis and stenosis maintains stability and may avoid the need for fusion

Abstract: Microendoscopic laminotomy is an effective form of surgical treatment for patients with DS and stenosis. Preservation of the stabilizing structures using this technique prevents postoperative instability. Cite this article: Bone Joint J 2018;100-B:499-506.

Cited by 46 publications

References 24 publications

Efficacy of percutaneous transforaminal endoscopic decompression treatment for degenerative lumbar spondylolisthesis with spinal stenosis in elderly patients

Efficacy of percutaneous transforaminal endoscopic decompression treatment for degenerative lumbar spondylolisthesis with spinal stenosis in elderly patients

Decompression Surgery versus Interspinous Devices for Lumbar Spinal Stenosis: A Systematic Review of the Literature

Effectiveness of posterior percutaneous full-endoscopic cervical foraminotomy for cervical osseous foraminal stenosis

Contact Info

Product

Resources

About