Minimally invasive surgery through endoscopic laminotomy and foraminotomy for the treatment of lumbar spinal stenosis

Polikandriotis, John A.; Hudak, Elizabeth M.; Perry, Michael

doi:10.1016/j.jor.2013.01.006

Cited by 27 publications

(24 citation statements)

References 13 publications

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“…Accordingly, the postoperative mean values of the walking ability after hemilaminectomy are superior to those of fenestration by 0.4 to 0.5 points (►Fig. 3). No significant effects were found regarding sleeping disorders related to lumbar discomfort.…”

Section: Resultsmentioning

confidence: 97%

“…Patients who do not respond to conservative therapies like analgesic therapy, steroid injections, chiropractic, or physiotherapy, or those whose impairments worsen under conservative therapy, ultimately choose surgery to get rid of their pain. 3 In an extensive study (Spine Patient Outcome Research Trial [SPORT]), Weinstein et al showed that patients who underwent surgery had a significantly better outcome than those who only had conservative therapy. 4 Irradiating pain, spinal claudication and QOL are improved by surgery 5 .…”

Section: Introductionmentioning

confidence: 99%

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Retrospective Matched-Pair Cohort Study on Effect of Bisegmental Fenestration versus Hemilaminectomy for Bisegmental Spinal Canal Stenosis at L3–L4 and L4–L5

Schüppel

Weber

2017

J Neurol Surg A Cent Eur Neurosurg

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The main symptoms of degenerative lumbar spinal canal stenosis are progressive back pain, spinal claudication, and, occasionally, sensory and motor deficits. Impairments particularly occur during walking, standing, and sitting. Thus social and vocational activities are increasingly restricted, causing considerable suffering for patients. Surgical therapies are superior to conservative ones. This article studies the outcome of 2-level fenestration versus hemilaminectomy for bisegmental spinal stenosis decompression. This retrospective matched-pair cohort study included a total of 144 patients who underwent surgery for bisegmental spinal stenosis at the levels L3-4 and L4-5 between 2008 and 2012. There were 72 matching pairs that corresponded in sex, year of birth, and width of the stenosed segments. The patients' impairments were reported before, immediately after, and 6 and 12 months after surgery using the Oswestry Disability Questionnaire (ODQ-D) and the EuroQol-5D (EQ-5D). The data were evaluated statistically. The comparison of both surgical procedures regarding walking ability (walking a distance with and without a walking aid) revealed a significant difference. Patients who underwent hemilaminectomy had better postoperative results. The individual criteria of the ODQ-D and EQ-5D revealed no significant differences between 2-level fenestration and hemilaminectomy; however, there is always significant postoperative improvement in comparison with preoperative status. Age, sex, body mass index, comorbidities, smoking, and alcohol consumption had no influence on the surgical results. The reoperation rate was between 13% and 15% for both surgical techniques, not being significantly different. Fenestration and hemilaminectomy are equivalent therapies for bisegmental lumbar spinal canal stenosis. Regarding walking, the study revealed better results for hemilaminectomy than for fenestration in this cohort of patients. Pain intensity, personal care, lifting and carrying of objects, sitting, social life, and travel all improved significantly postoperatively as compared with preoperatively. In both groups, health status as the decisive predictor improved considerably after surgery. We could show that both surgical methods result in significant postoperative improvement of all the individual criteria of the ODQ-D and the EQ-5D.

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Section: Resultsmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Retrospective Matched-Pair Cohort Study on Effect of Bisegmental Fenestration versus Hemilaminectomy for Bisegmental Spinal Canal Stenosis at L3–L4 and L4–L5

Schüppel

Weber

2017

J Neurol Surg A Cent Eur Neurosurg

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“…Endoscopic and open procedure of lumbar spine has its advantages and limitations, and the decision about which been performed should mainly be based on the pathologic features of the lumbar. [21][22][23] Degenerative lumbar spondylolisthesis in adults is characterized by the loss of disk height across the affected segment with sagittal translational and is often coupled with rotational deformity. [5] The goal of the surgical treatment of spondylolisthesis was stabilization of the motion segment, decompression of neural elements, reconstitution of disk space height, and restoration of sagittal plane translational and rotational alignment.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic transforaminal lumbar interbody fusion in the treatment of degenerative lumbar spondylolisthesis

Yan

Zhang²,

Zhang

2020

Preprint

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Background Transforaminal lumbar interbody fusion (TLIF) has been widely accepted as a standard treatment option for the patients with lumbar spondylolisthesis with good clinical outcomes. However, some patients suffered from the back pain postoperatively. With the development of minimally invasive endoscopic methods in spine surgery, the current trend of evolution lumbar spinal surgery has been toward endoscopic procedures.Purpose The purpose of this study was to evaluate the clinical outcomes and efficacy of endoscopic transforaminal lumbar interbody fusion (ELIF) in the treatment of degenerative lumbar spondylolisthesis by compare to the standard transforaminal lumbar interbody fusion (TLIF).Methods A total of 93 patients with lumbar spondylolisthesis who had surgery from February 2016 to January 2018 were categorized into different groups depending on the procedure by ELIF or TLIF. The ELIF and TLIF procedures was performed, and the clinical outcomes of blood loss, operation times, hospital stay days, pain index, ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were recorded.Results In ends 86 cases had follow-up at least one year and seven cases lost, and the follow-up rate and followed time were no difference between two groups (P > 0.05). The operational time was longer in ELIF than TLIF (P < 0.01).The hospital days and blood loss were significant less in endoscopic group than TLIF (P < 0.01). The pain index and ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were better than preoperational (P < 0.01), and there were no difference between two groups (P > 0.05). All patients achieved spinal fusion with no cases of cage extrusion, and no infection, and no dural tear of cerebrospinal fluid leakage complication. There were one case of radiculitis (man) at endoscopic group. CT-myelogram revealed the radiculitis patients had normal radiologic findings, and the patient was recovered by neurotrophy drugs and functional exercises after 3 months. Conclusions Endoscopic lumbar decompression and interbody fusion procedures was an effective and safe measure in the treatment of the lumbar spondylolisthesis. Compare to open interbody fusion techniques, endoscopic lumbar interbody fusion was a minimally invasive surgery with less bold loss discectomy. Eur Spine J 22 (4):727-733.

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“…Endoscopic and open procedure of lumbar spine has its advantages and limitations, and the decision about which to perform should mainly be based on the pathologic features of the lumbar. [21][22][23] Degenerative spondylolisthesis in adults is characterized by the loss of disk height across the affected segment with sagittal translational and is often coupled with rotational deformity. instrumented.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic transforaminal lumbar interbody fusion in the treatment of degenerative lumbar spondylolisthesis

Yan¹,

Zhang²,

Zhang³

2019

Preprint

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Background There were no studies in literature of lumbar spondylolisthesis treated by endoscopic surgery. The purpose of this study was to evaluate the efficacy of endoscopic transforaminal lumbar interbody fusion (ELIF) in the treatment of degenerative lumbar spondylolisthesis by compare to the standard transforaminal lumbar interbody fusion (TLIF).Methods A total of 93 patients with lumbar spondylolisthesis who had surgery from February 2017 to January 2018 were categorized into different groups depending on the procedure by ELIF or TLIF. The ELIF and TLIF procedures was performed, and the clinical outcomes of blood loss, operation times, hospital stay days, pain index, ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were recorded.Results There was no intraoperative death in this series. In ends 86 cases had follow-up at least one year and 7 cases lost, and the follow-up rate and followed time were no difference between two groups (P > 0.05). The operational time was longer in ELIF than TLIF (P < 0.01).The hospital days and blood loss were significant less in endoscopic group than TLIF (P < 0.01). The pain index and ODI score, the spondylolisthesis rate and reduction rate, and the disk height and intervertebral foramen height were better than preoperational (P < 0.01), and there were no difference between two groups (P > 0.05). All patients achieved spinal fusion with no cases of cage extrusion, and no infection, and no dural tear of cerebrospinal fluid leakage complication. There were one case of radiculitis (man) at endoscopic group. CT-myelogram revealed the radiculitis patients had normal radiologic findings, and the patient was recovered by neurotrophy drugs and functional exercises after 3 months.Conclusions Endoscopic lumbar decompression and interbody fusion procedures was effective and safe measure in the treatment of the lumbar spondylolisthesis. Compare to open interbody fusion techniques, endoscopic lumbar interbody fusion was minimally invasive surgery with less bold loss and earlier postoperative recovery.

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Minimally invasive surgery through endoscopic laminotomy and foraminotomy for the treatment of lumbar spinal stenosis

Cited by 27 publications

References 13 publications

Retrospective Matched-Pair Cohort Study on Effect of Bisegmental Fenestration versus Hemilaminectomy for Bisegmental Spinal Canal Stenosis at L3–L4 and L4–L5

Retrospective Matched-Pair Cohort Study on Effect of Bisegmental Fenestration versus Hemilaminectomy for Bisegmental Spinal Canal Stenosis at L3–L4 and L4–L5

Endoscopic transforaminal lumbar interbody fusion in the treatment of degenerative lumbar spondylolisthesis

Endoscopic transforaminal lumbar interbody fusion in the treatment of degenerative lumbar spondylolisthesis

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