Full-Endoscopic Lumbar Decompression versus Open Decompression and Fusion Surgery for the Lumbar Spinal Stenosis: A 3-Year Follow-Up Study

Song, Qingpeng; Zhu, Bin; Zhao, Wenkui; Chen, Liang; Bai, Hai; Liu, Xiaoguang

doi:10.2147/jpr.s309693

Cited by 16 publications

(14 citation statements)

References 34 publications

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“…PETD can not only remove disc herniation but also hyperplastic facet joints, hypertrophic ligamentum flavum, and osteophytes, which can increase the scale of the foramen, lateral recess, and even the central canal. According to a few studies, PETD showed clinical outcomes comparable to the conventional open decompression and fusion surgery, with advantages of lesser tissue trauma, faster rehabilitation, and lower intraoperative blood loss, risk of degeneration of adjacent segments and cost of postoperative care [ 8 – 10 ]. However, surgery-related complications have become more common and inevitable because of the widespread use of PETD, which makes patients dissatisfied with the postoperative efficacy.…”

Section: Introductionmentioning

confidence: 99%

Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis

Fan

Yuan

et al. 2021

BMC Musculoskelet Disord

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Background With the advancements in surgical methods, optical designs, and surgical instruments, percutaneous endoscopic transforaminal discectomy (PETD) has become an effective and minimally invasive procedure to treat lumbar spinal stenosis (LSS) in recent years. Few studies have focused on the complications associated with the treatment of LSS using percutaneous endoscopic lumbar discectomy (PELD). This study aimed to summarize the complications of PETD and identify the associated risk factors. Methods Complications in a total of 738 consecutive LSS patients who underwent single-level PETD were retrospectively recorded and analyzed between January 2016 and July 2020. In addition, a matched case-control study was designed, and according to the date of operation, the control group was matched with patients without complications, with a matching ratio of 1:3. Demographic parameters included age, sex, BMI, smoking and drinking status, comorbidity, and surgical level. The radiological parameters included grade of surgical-level disc degeneration, number of degenerative lumbar discs, grade of lumbar spinal stenosis, degenerative lumbar scoliosis, lumbar lordosis, disc angle, and disc height index. Univariate analysis was performed using independent samples t-test and chi-squared test. Results The incidence of different types of complications was 9.76% (72/738). The complications and occurrence rates were as follows: recurrence of LSS (rLSS), 2.30% (17/738); persistent lumbosacral or lower extremity pain, 3.79% (28/738); dural tear, 1.90% (14/738); incomplete decompression, 0.81% (6/738); surgical site infection, 0.41% (3/738); epidural hematoma, 0.27% (2/738); and intraoperative posterior neck pain, 0.27% (2/738). Univariate analysis demonstrated that age, the grade of surgical-level disc degeneration (P < 0.001) and the number of disc degeneration levels (P = 0.004) were significantly related to the complications. Conclusion Complications in the treatment of LSS using PELD included rLSS, persistent pain of the lumbosacral or lower extremity, dural tear, incomplete decompression, surgical site infection, epidural hematoma, and intraoperative posterior neck pain. In addition, old age, severe grade of surgical-level disc degeneration and more disc degeneration levels significantly increased the incidence of complications.

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Section: Introductionmentioning

confidence: 99%

Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis

Fan

Yuan

et al. 2021

BMC Musculoskelet Disord

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“…Due to its relative conservative approach and lower complication rate, it is a preferred surgical option for the elderly (9).However, traditional laminectomy decompression surgery may lead to damage to the posterior lumbar muscle structure, particularly the multi dus muscle. The subsequent loss of innervation and fat in ltration may be associated with chronic lower back pain and failed back surgery syndrome (10). As a result, there has been a shift in focus towards minimally invasive surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Endoscopic Interlaminar Decompression in Lumbar Spinal Stenosis:A Retrospective Study

Qu,

Zhang,

xie

et al. 2024

Preprint

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This study aims to assess the clinical effectiveness of endoscopic interlaminar decompression for lumbar spinal stenosis. Methods: A retrospective analysis was conducted on 40 patients who underwent lumbar decompression via an interlaminar approach under spinal endoscopy in our institution from February 2020 to January 2022. The early therapeutic outcome was evaluated using the Visual Analogue Scale (VAS), Japanese Orthopaedic Association Evaluation score (JOA), and modified Macnab efficacy criteria.Results: All 40 patients successfully underwent the decompression operation. One patient experienced a dural sac injury, while the others had no complications such as dural, nerve root, or vascular injuries. The VAS and JOA scores were significantly improved post-operation (P < 0.05). At the last follow-up, the modified Macnab criterion indicated an excellent and good rate of 87.5%. None of the 40 patients underwent revision surgery during the follow-up period.Conclusion: Decompression surgery conducted via an endoscopic interlaminar approach demonstrates commendable clinical efficacy, safety, and contributes to an earlier resumption of activity post-surgery.

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“…Within natural aging and lumbar spine degeneration, lumbar degenerative disease is characterized by hypertrophy of facet joint and ligamentum flavum, degeneration of intervertebral disc, collapse of intervertebral space, and osteophyte formation 1 , 2 . This disease can cause pain and disability, place a heavy burden on the health care system, and restrict economic development.…”

Section: Introductionmentioning

confidence: 99%

Long-term efficacy of Waveflex semi-rigid-dynamic-internal-fixation system in delaying intervertebral disc degeneration at adjacent segments and improving spinal sagittal imbalance

Gao,

Wang,

Chen

et al. 2024

Sci Rep

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The Waveflex semi-rigid-dynamic-internal-fixation system shows good short-term effects in the treatment of lumbar degenerative diseases, but there are few long-term follow-up studies, especially for recovery of sagittal balance. Fifty patients with lumbar degenerative diseases treated from January 2016 to October 2017 were retrospectively analysed: 25 patients treated with Waveflex semi-rigid-dynamic-internal-fixation system (Waveflex group) and 25 patients treated with double-segment PLIF (PLIF group). Clinical efficacy was evaluated by Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). Imaging data before surgery and at 3 months, 1 year, and 5 years postoperatively was used for imaging indicator assessment. Local disc degeneration of the cephalic adjacent segment (including disc height index (DHI), intervertebral foramen height (IFH), and range of motion (ROM)) and overall spinal motor function (including lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), and |PI-LL|) were analysed. Regarding clinical efficacy, comparison of VAS and ODI scores between the Waveflex and PLIF groups showed no significant preoperative or postoperative differences. The comparison of the objective imaging indicators showed no significant differences in the DHI, IFH, LL, |PI-LL|, and SS values between the Waveflex and PLIF groups preoperatively and 3 months postoperatively (P > 0.05). These values were significantly different at 1 and 5 years postoperatively (P < 0.05), and the Waveflex group showed better ROM values than those of the PLIF group (P < 0.05). PI values were not significantly different between the groups, but PT showed a significant improvement in the Waveflex group 5 years postoperatively (P < 0.05). The Waveflex semi-rigid dynamic fixation system can effectively reduce the probability of intervertebral disc degeneration in upper adjacent segments. Simultaneously, patients in the Waveflex group showed postoperative improvements in LL, spinal sagittal imbalance, and quality of life.

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Full-Endoscopic Lumbar Decompression versus Open Decompression and Fusion Surgery for the Lumbar Spinal Stenosis: A 3-Year Follow-Up Study

Cited by 16 publications

References 34 publications

Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis

Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis

Clinical Efficacy of Endoscopic Interlaminar Decompression in Lumbar Spinal Stenosis:A Retrospective Study

Long-term efficacy of Waveflex semi-rigid-dynamic-internal-fixation system in delaying intervertebral disc degeneration at adjacent segments and improving spinal sagittal imbalance

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