Pain improvement and reoperation rate after full-endoscopic decompression for lateral recess stenosis: a 10-year follow-up

Abstract

Purpose To share long-term clinical outcomes and our experience with full-endoscopic interlaminar decompression (FEI) for lateral recess stenosis (LRS). Methods We included all patients who underwent FEI for LRS from 2009 to 2013. VAS for leg pain, ODI, neurological findings, radiographic findings, and complications were analyzed at one week, one month, three months, and one year postoperation. The telephone interview for local patients with simple questions was done approximately ten years after the operation. International patients receive an email with the same questionnaire as local patients during the same follow-up period. Results One hundred and twenty-nine patients underwent FEI for LRS with complete data during 2009–2013. Most of the patients (70.54%) had LRS radiculopathy for less than one year, mainly L4-5 (89.92%), followed by L5-S1 (17.83%). Early outcomes three months after surgery showed that most patients (93.02%) reported significant pain relief, and 70.54% reported no pain at their ODI scores were significantly reduced from 34.35 to 20.32% (p = 0.0052). In contrast, the mean VAS for leg pain decreased substantially by 3.77 points (p < 0.0001). There were no severe complications. At ten years of follow-up, 62 patients responded to the phone call or email. 69.35% of the patients reported having little or no back or leg pain, did not receive any further lumbar surgery, and were still satisfied with the result of the surgery. There were six patients (8.06%) who underwent reoperation. Conclusion FEI for LRS was satisfactory at 93.02%, with a low complication rate during the early follow-up period. Its effect seems to decline slightly in the long term at a 10-year follow-up. 8.06% of the patients subsequently underwent reoperation.

Microsurgical and Descriptive Three-Dimensional Analysis of the Subarticular Trigone: A Guidemap for Standardizing Lateral Recess Decompression

“…In recent decades, compression of the traversing nerve root within the subarticular gutter has emerged as one of the most prevalent degenerative pathologies treated by spinal surgeons. Addressing such compressions involves a range of treatment modalities, spanning from nerve root injections and open lateral recess decompressions through unilateral selective approaches to minimally invasive techniques and more recently endoscopic approaches [ 4 , 5 , 7 , 8 , 19 , 20 ]. Alongside a gross anatomical delineation of the lateral recess, a microsurgical comprehension of the involved region is imperative to ensure thorough decompression without extensive facet/pars damage that would lead to instability, as well as procedural reproducibility, thereby mitigating the learning curve associated with these techniques.…”