Hyeun Sung Kim1, Ravish Patel2, Byapak Paudel1, Jee-Soo Jang1, Il-Tae Jang3, Seong-Hoon Oh4, Jae Eun Park5, Sol Lee5. 1. Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, South Korea. 2. Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, South Korea. Electronic address: ravishspine@gmail.com. 3. Department of Neurosurgery, Nanoori Hospital, Seoul, South Korea. 4. Department of Neurosurgery, Nanoori Incheon Hospital, Incheon, South Korea. 5. Nanoori Medical Research Institute, Nanoori Hospital, Seoul, South Korea.
Abstract
OBJECTIVE: Percutaneous endoscopic contralateral interlaminar lumbar foraminotomy (PECILF) for lumbar degenerative spinal stenosis is an established procedure. Better preservation of contralateral facet joint compared with that of the approach side has been shown with uniportal bilateral decompression. The aim of this retrospective case series was to analyze the early clinical and radiologic outcomes of stand-alone contralateral foraminotomy and lateral recess decompression using PECILF. METHODS: Twenty-six consecutive patients with unilateral lower limb radiculopathy underwent contralateral foraminotomy and lateral recess decompression using PECILF. Their clinical outcomes were evaluated with visual analog scale leg pain score, Oswestry Disability Index, and the MacNab criteria. Completeness of decompression was documented with a postoperative magnetic resonance imaging. RESULTS: Mean age for the study group was 62.9 ± 9.2 years and the male/female ratio was 4:9. A total of 30 levels were decompressed, with 18 patients (60%) undergoing decompression at L4-L5, 9 at L5-S1 (30%), 2 at L3-L4 (6.7%), and 1 at L2-L3 (3.3%). Mean estimated blood loss was 27 ± 15 mL per level. Mean operative duration was 48 ± 12 minutes/level. Visual analog scale leg score improved from 7.7 ± 1 to 1.8 ± 0.8 (P < 0.0001). Oswestry Disability Index improved from 64.4 ± 5.8 to 21 ± 4.5 (P < 0.0001). Mean follow-up of the study was 13.7 ± 2.7 months. According to the MacNab criteria, 10 patients (38.5%) had good results, 14 patients (53.8%) had excellent results, and 2 patients (7.7%) had fair results. One patient required revision surgery. CONCLUSIONS: Facet-preserving contralateral foraminotomy and lateral recess decompression with PECILF is effective for treatment of lateral recess and foraminal stenosis. Thorough decompression with acceptable early clinical outcomes and minimal perioperative morbidity can be obtained with the contralateral endoscopic approach.
OBJECTIVE: Percutaneous endoscopic contralateral interlaminar lumbar foraminotomy (PECILF) for lumbar degenerative spinal stenosis is an established procedure. Better preservation of contralateral facet joint compared with that of the approach side has been shown with uniportal bilateral decompression. The aim of this retrospective case series was to analyze the early clinical and radiologic outcomes of stand-alone contralateral foraminotomy and lateral recess decompression using PECILF. METHODS: Twenty-six consecutive patients with unilateral lower limb radiculopathy underwent contralateral foraminotomy and lateral recess decompression using PECILF. Their clinical outcomes were evaluated with visual analog scale leg pain score, Oswestry Disability Index, and the MacNab criteria. Completeness of decompression was documented with a postoperative magnetic resonance imaging. RESULTS: Mean age for the study group was 62.9 ± 9.2 years and the male/female ratio was 4:9. A total of 30 levels were decompressed, with 18 patients (60%) undergoing decompression at L4-L5, 9 at L5-S1 (30%), 2 at L3-L4 (6.7%), and 1 at L2-L3 (3.3%). Mean estimated blood loss was 27 ± 15 mL per level. Mean operative duration was 48 ± 12 minutes/level. Visual analog scale leg score improved from 7.7 ± 1 to 1.8 ± 0.8 (P < 0.0001). Oswestry Disability Index improved from 64.4 ± 5.8 to 21 ± 4.5 (P < 0.0001). Mean follow-up of the study was 13.7 ± 2.7 months. According to the MacNab criteria, 10 patients (38.5%) had good results, 14 patients (53.8%) had excellent results, and 2 patients (7.7%) had fair results. One patient required revision surgery. CONCLUSIONS: Facet-preserving contralateral foraminotomy and lateral recess decompression with PECILF is effective for treatment of lateral recess and foraminal stenosis. Thorough decompression with acceptable early clinical outcomes and minimal perioperative morbidity can be obtained with the contralateral endoscopic approach.
Authors: Christoph P Hofstetter; Yong Ahn; Gun Choi; J N A Gibson; S Ruetten; Yue Zhou; Zhen Zhou Li; Christoph J Siepe; Ralf Wagner; Jun-Ho Lee; Koichi Sairyo; Kyung Chul Choi; Chien-Min Chen; A E Telfeian; Xifeng Zhang; Arun Banhot; Pramod V Lokhande; N Prada; Jian Shen; F C Cortinas; N P Brooks; Peter Van Daele; Vit Kotheeranurak; Saqib Hasan; Gun Keorochana; Mohammed Assous; Roger Härtl; Jin-Sung Kim Journal: Global Spine J Date: 2020-05-28
Authors: Ji Yeon Kim; Hyeun Sung Kim; Jun Bok Jeon; Jun Hyung Lee; Jun Hwan Park; Il-Tae Jang Journal: J Clin Med Date: 2021-03-26 Impact factor: 4.241