FULL-ENDOSCOPIC TRANSFORAMINAL DECOMPRESSION TO TREAT A HIGH-RISK PATIENT WITH LUMBAR SPINAL STENOSIS AND DEGENERATIVE SPONDYLOLISTHESIS: A CASE REPORT AND LITERATURE REVIEW

Abstract

Lumbar spinal stenosis (LSS) with degenerative spondylolisthesis (DS) is prevalent in the aging population while they often have multiple comorbidities which are related to the higher risk for general anesthesia. Full-endoscopic transforaminal decompression (FETD) has been utilized under local anesthesia to remove herniated intervertebral disc, resect hypertrophic ligament and enlarged bone spur in order to decompress the affected neural structure without compromising the stability. In this study, we would present that a 71-year-old male patient, who had multiple comorbidities, underwent FETD to treat LSS with DS. We also conducted literature review to illustrate the feasibility of FETD in the treatment of LSS with DS. Reviewing 80 patients with LSS and DS in the four case-series studies, there was no difference in vertebral slippage percentage before and after operation. The overall complication rate was 3.75%, including three patients who had small dural tears which did not develop neurological sequelae during the follow-up period and did not require surgical or medical intervention. Four patients (5%) underwent reoperation due to recurrent or persistent sciatica symptoms. In conclusion, FETD can not only provide complete decompression but also maintain the original stability in treatment of LSS with DS. FETD can be an effective and safe approach to treat lumbar spinal stenosis with degenerative spondylolisthesis and can be an alternative for patients with multiple comorbidities or high risks for general anesthesia.