Hiroki Iwai1,2,3, Yasushi Oshima2,3,4, Tomoaki Kitagawa5, Hirokazu Inoue2,3,6, Yuichi Takano1,2,3, Hirohiko Inanami1,2,3, Hisashi Koga1,2,3. 1. Iwai FESS Clinic, Tokyo, Japan. 2. Department of Orthopaedics, Iwai Orthopaedic Medical Hospital, Tokyo, Japan. 3. Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital, Tokyo, Japan. 4. Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan. 5. Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan. 6. Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
Abstract
BACKGROUND: Full-endoscopic spine surgery (FESS) is a suitable treatment for lumbar disc herniation (LDH) and foraminal stenosis. This study investigated the usefulness of FESS in treating adjacent segment disease (ASD) after lumbar interbody fusion (LIF). METHODS: Between September 2015 and March 2019, a total of 13 patients with symptomatic ASD after LIF underwent FESS. Discectomy and foraminoplasty using a 3.5-mm diameter high-speed drill were performed for treating LDH and foraminal stenosis. Preoperative and postoperative statuses were evaluated using Numerical Rating Scale (NRS) and the modified Japanese Orthopedic Association (mJOA) scores. RESULTS: The patients' mean age was 64.8 years; there were 10 male and 3 female patients. The mean operative time was 52.7 min. The mean pre- and postoperative NRS scores were 7.6 and 3.1, respectively. The mean pre- and postoperative mJOA scores were 10.5 and 16.1, respectively, and the mean recovery rate was 32.8%. Subsequent operative treatments were required in 3 patients for postoperative complication, insufficient decompression, and recurrence LDH. CONCLUSIONS: FESS is a safe and effective minimally invasive treatment for ASD after LIF and a potential alternative to extend the LIF to the adjacent vertebra or sacrum. 2020 Journal of Spine Surgery. All rights reserved.
BACKGROUND: Full-endoscopic spine surgery (FESS) is a suitable treatment for lumbar disc herniation (LDH) and foraminal stenosis. This study investigated the usefulness of FESS in treating adjacent segment disease (ASD) after lumbar interbody fusion (LIF). METHODS: Between September 2015 and March 2019, a total of 13 patients with symptomatic ASD after LIF underwent FESS. Discectomy and foraminoplasty using a 3.5-mm diameter high-speed drill were performed for treating LDH and foraminal stenosis. Preoperative and postoperative statuses were evaluated using Numerical Rating Scale (NRS) and the modified Japanese Orthopedic Association (mJOA) scores. RESULTS: The patients' mean age was 64.8 years; there were 10 male and 3 female patients. The mean operative time was 52.7 min. The mean pre- and postoperative NRS scores were 7.6 and 3.1, respectively. The mean pre- and postoperative mJOA scores were 10.5 and 16.1, respectively, and the mean recovery rate was 32.8%. Subsequent operative treatments were required in 3 patients for postoperative complication, insufficient decompression, and recurrence LDH. CONCLUSIONS: FESS is a safe and effective minimally invasive treatment for ASD after LIF and a potential alternative to extend the LIF to the adjacent vertebra or sacrum. 2020 Journal of Spine Surgery. All rights reserved.
Authors: Daniel K Resnick; William C Watters; Alok Sharan; Praveen V Mummaneni; Andrew T Dailey; Jeffrey C Wang; Tanvir F Choudhri; Jason Eck; Zoher Ghogawala; Michael W Groff; Sanjay S Dhall; Michael G Kaiser Journal: J Neurosurg Spine Date: 2014-07