Percutaneous Full Endoscopic Bilateral Lumbar Decompression of Spinal Stenosis through Uniportal-Contralateral Approach: Techniques and Preliminary Results.

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Percutaneous Full Endoscopic Bilateral Lumbar Decompression of Spinal Stenosis through Uniportal-Contralateral Approach: Techniques and Preliminary Results.

World Neurosurg. 2017 Apr 04;:

Authors: Kim HS, Paudel B, Jang JS, Oh SH, Lee S, Park JE, Jang IT

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 (EMR) 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 visual analogue scale (VAS), MacNab criteria, Oswestry Disability Index (ODI), 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 (NIC) was 550 meters on average. Follow-up period was 7.75 ± 2.28 months (range 5 - 13 months). VAS and ODI 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 three cases (6.25%) and two cases (4.17%) required TLIF (Transforaminal lumbar interbody fusion) operation following this procedure.
CONCLUSION: 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.

PMID: 28389410 [PubMed - as supplied by publisher]

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