Hyeun Sung Kim1, Byapak Paudel2, Ji Soo Jang1, Seong Hoon Oh3, Sol Lee4, Jae Eun Park4, Il Tae Jang4. 1. Department of Neurosurgery, Nanoori Suwon Hospital, Suwon-si, Gyeonggi-do, Republic of Korea. 2. Department of Neurosurgery, Nanoori Suwon Hospital, Suwon-si, Gyeonggi-do, Republic of Korea. Electronic address: drbyapak@gmail.com. 3. Department of Neurosurgery, Nanoori Incheon Hospital, Bupyeong-gu, Incheon, Republic of Korea. 4. Department of Neurosurgery, Nanoori Seoul Hospital, Gangnam-gu, Seoul, Republic of Korea.
Abstract
BACKGROUND: When considering various risk factors such as age, comorbidities, and complications related to the surgical procedure itself, open surgery in degenerative spinal stenosis is likely to cause more complications. Here, we report the surgical procedure and preliminary clinical results of percutaneous endoscopic stenosis lumbar decompression (PESLD) technique using a uniportal-contralateral approach for bilateral decompression of degenerative spinal stenosis. MATERIALS AND METHODS: Electronic medical records of 48 consecutive patients who were treated between January 2016 and August 2016 were reviewed retrospectively. All patient received PESLD through the uniportal-contralateral approach. We analyzed the outcomes using the visual analogue scale, Macnab criteria, Oswestry Disability Index, and complication rate. RESULTS: There were 48 cases (15 men, 33 women). Mean age of patients was 62.44 ± 8.68 years. Mean symptom duration was 20.13 ± 16.87 months. Neurogenic intermittent claudication was 550 m on average. Follow-up period was 7.75 ± 2.28 months (range, 5-13 months). Visual analogue scale and Oswestry Disability Index decreased significantly (P < 0.001) and decreased by 1.073 and 5.795 odds ratio, respectively, in contralateral foraminotomy cases. Macnab outcome grade was good to excellent in 96% of patients. Dural tear occurred in 3 cases (6.25%), and 2 cases (4.17%) required transforaminal lumbar interbody fusion operation after this procedure. CONCLUSIONS: The preliminary result of this uniportal-contralateral PESLD technique is encouraging (96% demonstrated a good-to-excellent outcome), and the procedure is safe. However, we need long-term follow-up and a more detailed study for more accurate results of this technique.
BACKGROUND: When considering various risk factors such as age, comorbidities, and complications related to the surgical procedure itself, open surgery in degenerative spinal stenosis is likely to cause more complications. Here, we report the surgical procedure and preliminary clinical results of percutaneous endoscopic stenosis lumbar decompression (PESLD) technique using a uniportal-contralateral approach for bilateral decompression of degenerative spinal stenosis. MATERIALS AND METHODS: Electronic medical records of 48 consecutive patients who were treated between January 2016 and August 2016 were reviewed retrospectively. All patient received PESLD through the uniportal-contralateral approach. We analyzed the outcomes using the visual analogue scale, Macnab criteria, Oswestry Disability Index, and complication rate. RESULTS: There were 48 cases (15 men, 33 women). Mean age of patients was 62.44 ± 8.68 years. Mean symptom duration was 20.13 ± 16.87 months. Neurogenic intermittent claudication was 550 m on average. Follow-up period was 7.75 ± 2.28 months (range, 5-13 months). Visual analogue scale and Oswestry Disability Index decreased significantly (P < 0.001) and decreased by 1.073 and 5.795 odds ratio, respectively, in contralateral foraminotomy cases. Macnab outcome grade was good to excellent in 96% of patients. Dural tear occurred in 3 cases (6.25%), and 2 cases (4.17%) required transforaminal lumbar interbody fusion operation after this procedure. CONCLUSIONS: The preliminary result of this uniportal-contralateral PESLD technique is encouraging (96% demonstrated a good-to-excellent outcome), and the procedure is safe. However, we need long-term follow-up and a more detailed study for more accurate results of this technique.
Authors: Pang Hung Wu; Hyeun Sung Kim; Yeon Jin Lee; Dae Hwan Kim; Jun Hyung Lee; Jun Bok Jeon; Harshavardhan Dilip Raorane; Il-Tae Jang Journal: Brain Sci Date: 2020-06-15