A novel technology named as selective fenestration and axial decompression for the surgical management of lumbar degenerative diseases

Abstract

Study DesignA retrospective study. PurposeTo firstly introduce a new surgical techniquenamed asselectivefenestrationand axial decompression (SFAD) to improvethe surgical treatment effectsof lumbar degenerative diseases. Overview of literaturePosterior lumbar laminectomy and interbody fusion (LIF)is a standard surgical method for the treatment of lumbar degenerative diseases. However, its application has some limitations, and the incidence of spinal cord nerve injury is relatively high. MethodsThisretrospectiveclinicalstudy was conducted fromJanuary 2018 to February2020. A total of 101 eligible patients including 62 men and 39 women withlumbar disc herniation (LDH) or lumbar spinal stenosis (LSS)underwentLIF or SFADwere enrolled in this study.The average postoperative follow-up periodof the LIF and SFAD groups were 20.1 ± 3.7 months and 19.7 ± 4.1 months, respectively.The clinical effects,imaging manifestation,and postoperative complicationsin LIF and SFAD groups were analyzed. ResultsThe operative time, blood loss and hospital stay in SFAD group were significantly lower than those in LIF group (P < 0.05). Significant clinical improvements in VAS and ODIwere achieved in bothLIF and SFAD groupsafter surgery, respectively (P < 0.05).There was no statistical difference in improvements of VAS and ODI betweentheLIFandSFADgroups (P > 0.05).Similarly, improvementsofcobb angle ofoperated segment, intervertebral space height (ISH), intervertebral space foramen (IFH)andlumbar lordosis (LL)showed no statistical differencebetween thetwogroups (P > 0.05).Finally, theprevalence of complicationratesinLIF group were significantlyhigher than theSFADgroup during the follow-up period(P < 0.05) ConclusionsThe application ofSFADto the surgical treatment of lumbar degenerative diseases can realize the three-dimensional and precise decompression of spinal cord nerve, whichis one of the ideal alternatives to traditional LIF.