Percutaneous endoscopic ventral facetectomy: An innovative substitute of open decompression surgery for lateral recess stenosis surgical treatment?

Abstract

Background:Percutaneous transforaminal endoscopic surgery (PTES) constitutes an innovative method principally recruited for the treatment of lumbar disc herniation. Indication spectrum of PTES is constantly widened in current years. Hence, PTES has been proposed to represent a satisfactory alternative for the treatment of lateral recess stenosis (LRS), being defined as percutaneous endoscopic ventral facetectomy (PEVF) in these cases. The aim of this original study is to determine, for the first time in the literature, the outcomes of PEVF, especially in otherwise healthy nonelderly patients with LRS, alongside with special focus in health-related quality of life (HRQoL) assessment.Materials and Methods:Eighty-five otherwise healthy individuals from 58 to 64 years were diagnosed with LRS, being subjected to successful PEVF. Patients were prospectively evaluated in 6 weeks, in 3, 6, and 12 months, and in 2 years postoperatively. Visual analog scales (VASs) were separately utilized for leg and low back pain evaluation (VAS-LP and VAS-BP, respectively), whereas Short Form-36 (SF-36) questionnaire was sequentially implemented for HRQoL assessment.Results:All indexes of SF-36 as well as VAS-LP featured maximal amelioration in 6 weeks postoperatively, with subsequent further enhancement until 3 months and successor stabilization until 2 years. In contrast, VAS-BP presented minimal quantitative amelioration in 6 weeks, featuring no additional alterations. Values of all indexes in all follow-up intervals were demonstrated to be statistically significant in comparison with preoperative values (P < 0.05). No remarkable differentiation was observed between distinct parameters of SF-36.Conclusions:PEVF implementation in nonelderly patients with LRS was displayed to be safe and effective, providing alongside considerable improvement in HRQoL 2 years postoperatively.

Clinical Outcomes of TESSYS and TESSYS-ISEE Approach on Treatment of Lateral Recess Stenosis: A Comparison Study

“…Although most of our participants experienced symptom relief following procedures, however, complications (5.75%) and recurrence (1.15%) still occurred. TESSYS is emerging as an attractive minimally invasive surgical option in the treatment of LRS [12,17,18], and was routinely applied to treat LRS at our institution. TESSYS-ISEE was newly designed to treat LRS [13].…”

The role of full-endoscopic lumbar discectomy in patients with neurodegenerative disorders: Technical note and short literature review

“…[1,2,9,10] We, therefore, performed a minimally invasive TFED (e.g., preservation of dorsal musculature and spine anatomic elements, diminished traumatization, as well as minimization of intraoperative hemorrhage) under local anesthesia with mild sedation. [4][5][6][7][8] FELD has been performed in other patients with accompanying neurodegenerative disorders/Parkinson's disease (PD) [ Table 2]. [4,5] Kapetanakis et al first described performing TFED for LDH in 11 patients with PD versus ten patients with LDH and no accompanying comorbidities' comparable clinical improvement were observed in both groups.…”

“…Further, advantages include the ability to perform transforaminal full-endoscopic discectomy (TFED) or interlaminar full-endoscopic discectomy under local anesthesia and mild sedation. [4][5][6][7][8]…”

The Role of Full-Endoscopic Lumbar Discectomy in Surgical Treatment of Recurrent Lumbar Disc Herniation: A Health-Related Quality of Life Approach

“…The utilization of local anesthesia with mild sedation eliminates the potentiality of hazardous general anesthesia-related complications emergence. [8][9][10][22][23][24] Revision surgery for RLDH constitutes a challenge for the spine surgeon. The initial conventional open discectomy/microdiscectomy results in epidural scarring, primarily encountered around dura mater and nerve roots.…”

“…Remarkable surgical advantages as preservation of dorsal musculature and spine elements as well as minimization of perioperative morbidity are responsible for its exponential expansion in current years. [8][9][10] To our best knowledge, recruitment of FELD for RLDH after conventional open discectomy/ microdiscectomy has been described few times in the literature. [11][12][13][14][15][16] However, in none of these studies was patients' health-related quality of life (HRQoL) assessed, so that a more multifaceted evaluation of FELD for RL-DH could be accomplished.…”