Comparison of Outcomes of Lumbar Interbody Fusion and Full-endoscopic Laminectomy for L5 Radiculopathy Caused by Lumbar Foraminal Stenosis

Fujita, Muneyoshi; Inui, Takahiro; Oshima, Yasushi; Iwai, Hiroki; Inanami, Hirohiko; Koga, Hisashi

doi:10.2176/jns-nmc.2021-0381

Cited by 4 publications

(5 citation statements)

References 41 publications

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“…Data are presented as means and standard deviations (SD). The STATA version 16.0 (Stata Corp. LLC, College Station, TX, USA) was used for the following analyses: 1) t-test for continuous variables and chi-square test for categorical variables (comparison between demographic data and outcome measurements), 2) paired ttests (comparison between preoperative and postoperative outcome measurements) [5][6][7]. P-values of <0.05 were considered to indicate significant differences.…”

Section: Discussionmentioning

confidence: 99%

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Large-Scale Comparative Study Between Microendoscopic Laminectomy and Full-Endoscopic Laminectomy for the Treatment of Single-Level Lumbar Spinal Canal Stenosis

Takebayashi,

Fujita,

Inui

et al. 2024

Cureus

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Background: We previously compared the operative outcomes of microendoscopic laminectomy (MEL) and full-endoscopic laminectomy (FEL) for single-level lumbar spinal canal stenosis (LSCS). In this initial report, the operative outcomes of FEL were not inferior to those of MEL.Objective: The purpose of this study is to compare the outcomes of MEL and FEL for single-level LSCS on a large scale using widely used multiple evaluation methods.Methods: MEL was performed using a 16 mm tubular retractor and an endoscope, while FEL was performed using a 6.4 mm working channel endoscope. A retrospective study was performed on patients with LSCS treated with MEL (n = 355) or FEL (n = 154). Patient background and operative data were also collected. The Oswestry Disability Index (ODI), European Quality of Life-5 Dimensions (EQ-5D), and 36-item Short Form Survey (SF-36) scores were recorded preoperatively and 1-year postoperatively.Results: Background data of the two groups and the mean operation time (MEL, 72.1 m; FEL, 74.2 m) were not significant (p>0.2). The mean volumes of intraoperative bleeding (MEL, 25.2 ml; FEL, 10.3 ml) were significantly different (p<0.001). The mean postoperative hospital stays (MEL, 3.9 days; FEL, 2.1 days) were significantly different (p<0.001). Fifteen dural tears (MEL, 11; FEL, 4) and 1 surgical site infection (MEL, 1; FEL, 0) were observed but not significant (p>0.5). Reoperation was required for postoperative hematoma in five patients (MEL,3; FEL,2). Although the ODI, EQ-5D, and SF-36 scores improved significantly at one year postoperatively in the MEL and FEL groups (p<0.001), there were no significant differences between the two groups (p>0.1). Conclusion:The operative outcomes and minimal invasiveness were no statistical difference between the MEL and FEL groups. Further development of the operative techniques and the instruments of FEL are required to shorten the operation time.

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Section: Discussionmentioning

confidence: 99%

“…In contrast, full-endoscopic laminectomy (FEL) is classified as a full-endoscopic spine surgery (FESS) performed under continuous saline irrigation during surgery [5][6][7]. Therefore, a clear visual field is provided by the washout of intraoperative bleeding.…”

Section: Introductionmentioning

confidence: 99%

Large-Scale Comparative Study Between Microendoscopic Laminectomy and Full-Endoscopic Laminectomy for the Treatment of Single-Level Lumbar Spinal Canal Stenosis

Takebayashi,

Fujita,

Inui

et al. 2024

Cureus

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“…The average age of the patients in this study was slightly higher and many had mild foraminal stenosis. TLA can also enlarge the corresponding foramen in cases of foraminal stenosis by drilling the SAP [6][7][8].…”

Section: A a B B C Cmentioning

confidence: 99%

“…Foraminal LDH are located ventral to the facet joints, making them difficult to approach using a normal posterior approach while preserving the facet joints, possibly resulting in postoperative instability. Although various modifications of standard open and microsurgical techniques have been described for foraminal LDH [1,2,4,5], endoscopically approaching the fo-foraminal stenosis, is particularly effective for foraminal LDH protruding from the medial part of the foramen at the L5/S1 level [6][7][8]. Because the transverse diameter of the L5/S1 foramen is anatomically long, it is relatively difficult.…”

Section: Introductionmentioning

confidence: 99%

Translaminar Fully Endoscopic Discectomy for Lumbar Foraminal Disc Herniation: A Technical Note

Takebayashi,

Iwai,

Nanami

et al. 2023

J Minim Invasive Spine Surg Tech

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Lumbar disc herniations (LDHs) located in foraminal lesions are difficult to approach using the normal posterior approach while preserving the facet joints. The translaminar approach (TLA) of fully endoscopic spine surgery allows access to a foraminal lesion through a small fenestration on the isthmus of the vertebral lamina, thereby preventing facet joint destruction. TLA is particularly suitable for L5/S1 foraminal LDH cases where the transverse diameter of the foramen is anatomically long. From 2020 to 2022, TLA was performed in 17 patients with foraminal LDH (12 men and 5 women), with a mean age of 67 years. The operative levels were L3/4 in 1 case, L4/5 in 2 cases, and L5/S1 in 14 cases. The mean operative time was 72 minutes, and the mean blood loss was negligible in all patients. The mean postoperative hospital stay was 1.2 days, and no major complications occurred. The mean preoperative and postoperative Numerical Rating Scale scores for leg pain were 6.4 and 1.8, respectively, and the mean patient satisfaction score at 3 months after TLA was 7. In conclusion, TLA is a minimally invasive approach for foraminal LDH, with particular advantages for facet joint preservation.

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“…However, these types of symptoms do not always indicate the development of LFS. Therefore, it is necessary to improve the diagnostic procedures related to the described disease entity [6]. It is estimated that stenosis of the intervertebral foramina is a problem for about 8-11% of the population [7].…”

Section: Introductionmentioning

confidence: 99%

The Spatial Characteristics of Intervertebral Foramina within the L4/L5 and L5/S1 Motor Segments of the Spine

Nowak,

Dąbrowski,

Druszcz

et al. 2024

Applied Sciences

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The prevalence of lower back pain and radicular pain in the population requires more and more accurate diagnostic methods to more effectively prevent and treat patients with these ailments. In this paper, we focused on one of the causes of lower back pain and radicular pain—lumbar foraminal stenosis (LFS). The aim of the study is to assess the morphometry of the intervertebral canals in the lumbar spine at the levels of the L4/L5 and L5/S1 motor segments. The obtained results showed correlations between the circumference and the surface area on individual cross-sections of the intervertebral canals at the L4/L5 and L5/S1 levels and determined the approximate shape of the root canal and its variability. On this basis, we were able to determine the influences of the patient’s age and sex on the morphometric parameters of the intervertebral canals at the L4/L5 and L5/S1 levels. Further research is needed in this area, taking into account additional factors influencing the shape of intervertebral canals.

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Comparison of Outcomes of Lumbar Interbody Fusion and Full-endoscopic Laminectomy for L5 Radiculopathy Caused by Lumbar Foraminal Stenosis

Cited by 4 publications

References 41 publications

Large-Scale Comparative Study Between Microendoscopic Laminectomy and Full-Endoscopic Laminectomy for the Treatment of Single-Level Lumbar Spinal Canal Stenosis

Large-Scale Comparative Study Between Microendoscopic Laminectomy and Full-Endoscopic Laminectomy for the Treatment of Single-Level Lumbar Spinal Canal Stenosis

Translaminar Fully Endoscopic Discectomy for Lumbar Foraminal Disc Herniation: A Technical Note

The Spatial Characteristics of Intervertebral Foramina within the L4/L5 and L5/S1 Motor Segments of the Spine

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