The Therapeutic Evaluation of Spinal Canal Decompression by Using the TBEIS Technique in the Treatment of Lumbar Spinal Stenosis.

Kemin You,Hongze Chang,Liang Liu,Xiaodong Liu,Feng Cai,Yan Zhang,Bo Li

doi:10.1155/2020/6183027

Kemin You, Hongze Chang + Show 5 more

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https://doi.org/10.1155/2020/6183027

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Abstract

Objective To evaluate the clinical efficacy of the percutaneous endoscopic Transforaminal Broad Easy Immediate Surgery (TBEIS) technology in elderly patients with lumbar spinal stenosis (LSS). Methods From February 2016 to May 2018, 35 elderly patients with LSS were treated with the TBEIS technique. There were 23 males and 12 females, aged from 53 to 72 years with a median age of 63.1 years. Preoperative, 1 day, and 1 and 12 months postoperative visual analogue scale (VAS) scores and Oswestry Disability Index (ODI) were statistically analyzed. The modified MacNab criterion was used to assess the clinical effects. The radiological outcomes were evaluated by X-ray and computed tomography (CT). Results All of the operations were successful. The operative time ranged from 120 to 170 min with a median time of 148 min. All of the patients were followed up for 12 to 38 months with a median follow-up of 18 months. Preoperative, 1 day, and 1 and 12 months postoperative VAS leg scores were 6.91 ± 0.98, 1.69 ± 0.68, 1.23 ± 0.59, and 0.91 ± 0.61, respectively, and the VAS back scores improved from 4.51 ± 0.82 to 0.66 ± 0.68. The ODI scores were 63.82 ± 7.59, 38.79 ± 6.36, 24.79 ± 3.90, and 11.33 ± 3.92, respectively. Postoperative scores of VAS and ODI were obviously improved (P < 0.01). According to the modified MacNab criteria used to evaluate the clinical effects, 11 cases achieved excellent results, 18 cases achieved good results, 4 cases achieved fair results, and 2 cases achieved poor results. There were no neurovascular injury and other complications. Conclusions Treatment of LSS in the elderly patients by the TBEIS technology has good clinical efficacy, and the technique is safe and minimally invasive.

Highlights

Lumbar spinal stenosis (LSS) is a common spinal disease in the elderly
The inclusion criteria were as follows: (1) patients who were diagnosed with degenerative LSS with moderate to severe stenosis shown on cross-sectional magnetic resonance imaging (MRI) or computed tomography (CT) scan images [14]; (2) patients who were diagnosed with/without disk herniation; (3) patients who complained of intermittent neurogenic claudication with/without radicular leg pain; and (4) patients who accepted conservative treatments for more than 6 months
Severe stenosis is defined as severe obliteration of the anterior Cerebrospinal Fluid (CSF) space causing marked compression of the dural sac and inability to visually separate the nerves in the cauda equina from each other, appearing instead as one bundle

Summary

Introduction

Lumbar spinal stenosis (LSS) is a common spinal disease in the elderly. Some of them usually have an infirm condition, and traditional open surgery is not applicable to this group of patients [1, 2]. The development of minimally invasive spinal technology has overcome the disadvantages of traditional surgery and can better preserve the integrity of the posterior ligament complex of the spine [3, 4]. Yeung [5, 6] created the Yeung endoscopic spine system (YESS) on this basis. TESSYS technology and improved TESSYS technology have become increasingly popular in treating different types of lumbar disc herniation (LDH) [8,9,10,11,12]

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