Abstract
BackgroundLateral recess stenosis (LRS) is a common degenerative disease in the elderly. Since the rise of comorbidity is associated with increasing age, transforaminal endoscopic lateral recess decompression (TE-LRD) is advocated. The objective of this study was to compare the clinical outcomes of TE-LRD in patients with LRS via visualized drilled foraminoplasty (VDF) or visualized reamed foraminoplasty (VRF) technique.MethodsA total of 45 and 42 consecutive patients with limp or unilateral radiculopathy symptoms underwent TE-LRD using the VDF and VRF technique, respectively. The radiation exposure and operation time, time to return to work, and complications were compared between two groups. Their clinical outcomes were evaluated with the visual analogue scale (VAS) leg pain score, VAS back pain score, Oswestry Disability Index (ODI) and modified MacNab’s criteria.ResultsThe average values of radiation exposure and operative time in the VDF group were significantly higher than those in the VRF group (P < 0.05). The postoperative VAS and ODI scores in both groups were significantly improved compared with those before the operation (P < 0.05). In addition, the VAS score of the leg pain and ODI score in the VRF group were significantly lower than those in the VDF group at the 1-week follow-up (P < 0.05). The good-to-excellent rates of the VDF group and VRF group were 88.89 and 90.48%, respectively, whereas the complication occurrence rates were 6.67 and 4.76% in the VDF group and VRF group, respectively.ConclusionsTE-LRD performed by using VRF technique can be applied to treat LRS safely and effectively with short radiation exposure and operation time. This technique was comparable to the VDF technique with improved VAS leg pain and ODI scores in the short period after the operation. However, potential complications and risks still need to be considered.
Highlights
Lateral recess stenosis (LRS) is a common degenerative disease in the elderly
transforaminal endoscopic lateral recess decompression (TE-LRD) performed by using visualized reamed foraminoplasty (VRF) technique can be applied to treat LRS safely and effectively with short radiation exposure and operation time
Inclusion and exclusion criteria The following inclusion criteria were used to select the patients: i) All participants complained of neurogenic claudication or unilateral radiculopathy symptoms; ii) Degenerative unilateral LRS localized at one segment was diagnosed on computed tomography (CT) scanning and magnetic resonance imaging (MRI), ventral compression was caused by disc herniation and osteophytes, dorsal compression was due to hypertrophic ligamentum flavum (LF) and facet, or both [13] [15]; and the Bartynski Grading System was applied in our study [16]. iii) Neurological symptoms were consistent with Computed tomography (CT) scanning and Magnetic resonance imaging (MRI) findings; iv) Conservative treatments failed to relieve the symptoms within 6 weeks
Summary
Lateral recess stenosis (LRS) is a common degenerative disease in the elderly. Since the rise of comorbidity is associated with increasing age, transforaminal endoscopic lateral recess decompression (TE-LRD) is advocated. The objective of this study was to compare the clinical outcomes of TE-LRD in patients with LRS via visualized drilled foraminoplasty (VDF) or visualized reamed foraminoplasty (VRF) technique. Lumbar spinal stenosis (LSS) is a common degenerative disease in the elderly and can be categorized into central stenosis, lateral recess stenosis (LRS) and foraminal stenosis [1, 2]. The main purpose of surgical treatment is to decompress the spinal canal and relieve symptoms [6]. MISS is considered for patients with LSS if dynamic spinal instability wasn’t observed preoperatively [8, 9]
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