Percutaneous Transforaminal Endoscopic Decompression for Lumbar Lateral Recess Stenosis

Abstract

Objective: The aim of this study was to evaluate the treatment efficacy of lateral spinal stenosis through the decompression of the nerve root under a multiple planar endoscope.Methods: From January 2017 to March 2019, 52 patients with lumbar spinal stenosis or lumbar spinal stenosis combined with intervertebral disc herniation had been treated via transforaminal approach spinal endoscopy. Our study retrospectively analyzed the treatment outcome. All patients experienced complications with different degrees of facet joint hyperplasia and ligamentum flavum hyperplasia and hypertrophy. Some patients suffered disc herniation. All patients were treated with percutaneous transforaminal approach multiple planar endoscopic decompression. The visual analog scale (VAS) and the Oswestry Disability Index (ODI) were compared before and after the operation, as were the horizontal foramen areas of the medial margins of the upper and lower pedicles of the vertebral arch. The treatment effectiveness was evaluated.Results: VAS and ODI scores were significantly improved at postoperative 3 days, 3 months, 6 months, and the last follow-up (P < 0.05). The area of the intervertebral foramen was 422.5 ± 159.2 mm2 preoperatively and 890.8 ± 367.7 mm2 postoperatively, the difference was statistically significant (P < 0.05).Conclusion: Percutaneous transforaminal approach multiple planar endoscopic decompression could achieve an accurate and effective decompression of the lumbar lateral spinal canal. This procedure has good short-term effects, and is especially suitable for elderly patients.

A novel technique for decortication of the lumbar facet joints for posterolateral fusion with percutaneous exposure: A cadaveric feasibility study

“…Lumbar interbody fusion (LIF) is one of the most common surgeries performed on the spine, with tremendous advances in minimally invasive techniques over the last few decades. 11 , 12 Specifically, the percutaneous method of access has expanded over the years to cover decompression, 8 , 13 fixation, 14 , 15 , 16 and recently, fusion. 7 , 17 One of the longstanding criticisms of percutaneous access for LIF are the increased rates of pseudoarthrosis likely secondary to the restricted access afforded to not only decorticate, but place bone graft and interbody cages, despite techniques improving over the years.…”

“…Transforaminal lumbar interbody fusion (TLIF) has been explored with a percutaneous approach in recent years with and without endoscopy. 7 , 8 , 9 A clinical trial with an investigative percutaneous delivery system for a unique implant is underway in the cervical spine (NCT04229017). Although traditional screws have been delivered to the lumbar spine percutaneously, the use of these instruments (CORUS™ Spinal System-X; DI # 00852776006508) to supplement TLIFs with facet joint decortication has not been documented in the literature.…”

Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results

“…However, more recently, a broad range of surgical approaches for this type of decompression have been used, ranging from standard open laminectomies to endoscopic approaches using minimally invasive techniques. [34][35][36] Our group described a series of patients with symptomatic unilateral LRS who were treated successfully using interlaminar endoscopic decompression techniques. 17 Additional studies have demonstrated favorable clinical results comparing full-endoscopic with microsurgical techniques and highlighted the reduced approach-related morbidity afforded by a full-endoscopic approach.…”

Clinical Efficacy of Interlaminar and Transforaminal Spinal Endoscopy in the Treatment of Lumbar Spinal Stenosis

“…6 Now, it has been gradually applied to LSS treatment. 7,8 While providing effective decompression, the spinal endoscope is less traumatic and costly. 9 It can be done under local anesthesia, 10,11 effectively decreasing postoperative complications and making it more suitable for the elderly.…”