“U” route transforaminal percutaneous endoscopic thoracic discectomy as a new treatment for thoracic spinal stenosis

Zhao, Xin; Li, Xingchen; Zhou, Honggang; Cao, Xiaoqiang; Qidong, Yuan; Ma, Hui; Yang, Huanming; Wang, Bi-Sheng

doi:10.1007/s00264-018-4145-y

Cited by 48 publications

(43 citation statements)

References 23 publications

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“…To the best of our knowledge, all the published studies on prognostic factors in OLF patients have been based on traditional open surgery. However, MIS has been advantageous in treating OLF with satisfactory surgical results 12,[15][16][17] . This study investigated the prognostic factors following MIS and was based on the retrospective analysis of OLF patients who underwent percutaneous full endoscopic posterior decompression (PEPD).…”

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confidence: 99%

Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum

Gao

et al. 2020

Sci Rep

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Minimally invasive surgery (MIS) has shown satisfactory surgical results for the treatment of thoracic myelopathy (TM) caused by ossification of the ligamentum flavum (OLF). This study investigated the prognostic factors following MIS and was based on the retrospective analysis of OLF patients who underwent percutaneous full endoscopic posterior decompression (PEPD). Thirty single-segment OLF patients with an average age of 60.4 years were treated with PEPD under local anaesthesia. Clinical data were collected from the medical and operative records. The surgical results were assessed by the recovery rate (RR) calculated from the modified Japanese Orthopaedic Association (mJOA) score. Correlations between the RR and various factors were analysed. Patients' neurological status improved from a preoperative mJOA score of 6.0 ± 1.3 to a postoperative mJOA score of 8.5 ± 2.0 (P < 0.001) at an average follow-up of 21.3 months. The average RR was 53.8%. Dural tears in two patients (6.7%, 2/30) were the only observed complications. Multiple linear regression analysis showed that a longer duration of preoperative symptoms and the presence of a high intramedullary signal on T2-weighted MRI (T2HIS) were significantly associated with poor surgical results. PEPD is feasible for the treatment of TM patients with a particular type of OLF. Patients without T2HIS could achieve a good recovery if they received PEPD early. Thoracic myelopathy (TM) is less common than cervical myelopathy and lumbar spinal stenosis 1 , and TM is mainly caused by ossification of the ligamentum flavum (OLF) in East Asian countries, such as Japan, Korea, and China 2. As the number of reported cases has increased, OLF has been studied not only in East Asia but also worldwide 3-5. Although much of its pathophysiology has been determined, the exact pathogenetic mechanism and the epidemiology of OLF remain poorly understood 6,7. Therefore, making an appropriate and timely therapeutic decision for the treatment of OLF may be hindered by the paucity of knowledge. TM caused by OLF remains a challenge for spine surgeons. OLF generally requires posterior surgical decompression due to its progressive nature and poor response to conservative therapy 8,9. Decompression procedures include traditional open surgeries, such as laminectomy with or without posterior fusion 10,11 , and minimally invasive surgery (MIS), such as microendoscopic decompression 12,13 and percutaneous endoscopic decompression 14-17. However, the prognostic guidelines are still unclear, and the surgical results vary widely despite complete decompression 3,18 .

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confidence: 99%

Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum

Gao

et al. 2020

Sci Rep

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“…Pedicle screw fixation and fusion may be unnecessary, the medical costs may be reduced. Moreover, PED can reduce the length of hospitalization [ 21 ]. Besides, it can provide clear visualization with saline solution, which is helpful in improving safety of the elderly patients [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

A comparison study of percutaneous endoscopic decompression and posterior decompressive laminectomy in the treatment of thoracic spinal stenosis

Cheng

Bian

Liu

et al. 2020

BMC Musculoskelet Disord

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Background Percutaneous endoscopic decompression (PED) is considered a minimally invasive and safe procedure in lumbar degenerative disease. Few authors report the success of PED for thoracic spinal stenosis (TSS) with thoracic myelopathy. The objective of this study was to compare the outcome of PED versus posterior decompressive laminectomy (PDL) for TSS. Methods We retrospectively reviewed 30 consecutive patients who underwent surgery for single-level TSS from January 1, 2015 to May 1, 2019.These patients were divided into PED (n = 16) and PDL(n = 14) group. Preoperative demographic characteristics and perioperative outcomes were reviewed. Pre- and postoperative neurological status was evaluated using the modified Japanese Orthopaedic Association (mJOA) score and the recovery rate (RR). Results The patients’ mean age was 57.3 years (27–76) in PED group and 58.8 years (34–77) in PDL group. No statistical difference was found between two groups with regards to neurological status at pre-operative and final follow-up. The RR in PED group achieved the same improvement as PDL group (87.5% vs 85.7%, P > 0.05), while the PED brought advantages in operative time(m) (86.4 vs 132.1, p < 0.05), blood loss (mL) (18.21 vs 228.57, p < 0.05),drainage volume(mL) (15.5 vs 601.4, p < 0.05), and hospital stay (d) (3.6 vs 5.6, p < 0.05). Conclusions Both PED and PDL showed favorable outcome in the treatment of TSS. Besides, PED had advantages in reducing traumatization. In terms of perioperative quality of life, PED could be an efficient supplement to traditional posterior decompressive laminectomy in patients with TSS.

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“…Pedicle screw xation and fusion may be unnecessary, the medical costs may be reduced. Moreover, PED can reduce the length of hospitalization [21]. Besides, it can provide clear visualization with saline solution, which is helpful in improving safety of the elderly patients [22].…”

Section: Discussionmentioning

confidence: 99%

A comparison study of percutaneous endoscopic decompression and posterior decompressive laminectomy in the treatment of thoracic spinal stenosis

Cheng

Bian

Liu

et al. 2020

Preprint

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Background: Percutaneous endoscopic decompression (PED) is considered a minimally invasive and safe procedure in lumbar degenerative disease. Few authors report the success of PED for thoracic spinal stenosis (TSS) with thoracic myelopathy. The objective of this study was to compare the outcome of PED versus posterior decompressive laminectomy (PDL) for TSS.Methods: We retrospectively reviewed 30 consecutive patients who underwent surgery for single-level TSS from January 1, 2015 to May 1, 2019.These patients were divided into PED (n=16) and PDL(n=14) group. Preoperative demographic characteristics and perioperative outcomes were reviewed. Pre- and postoperative neurological status was evaluated using the modified Japanese Orthopaedic Association (mJOA) score and the recovery rate (RR).Results: The patients’ mean age was 57.3 years (27-76) in PED group and 58.8 years (34-77) in PDL group. No statistical difference was found between two groups with regards to neurological status at pre-operative and final follow-up. The RR in PED group achieved the same improvement as PDL group (87.5% vs 85.7%, P>0.05), while the PED brought advantages in operative time(m) (86.4 vs 132.1, p<0.05), blood loss (mL) (18.21 vs 228.57, p<0.05),drainage volume(mL) (15.5 vs 601.4, p<0.05), and hospital stay (d) (3.6 vs 5.6, p<0.05).Conclusions: Both PED and PDL showed favorable outcome in the treatment of TSS. Besides, PED had advantages in reducing traumatization. In terms of perioperative quality of life, PED could be an efficient supplement to traditional posterior decompressive laminectomy in patients with TSS.

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“U” route transforaminal percutaneous endoscopic thoracic discectomy as a new treatment for thoracic spinal stenosis

Abstract: This retrospective analysis shows that "U" route PETD for decompression may be a feasible alternative to treat thoracic spinal stenosis.

Cited by 48 publications

References 23 publications

Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum

Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum

A comparison study of percutaneous endoscopic decompression and posterior decompressive laminectomy in the treatment of thoracic spinal stenosis

A comparison study of percutaneous endoscopic decompression and posterior decompressive laminectomy in the treatment of thoracic spinal stenosis

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