Percutaneous endoscopic transforaminal lumbar spinal canal decompression for lumbar spinal stenosis

Wen, Bingtao; Zhang, Xifeng; Zhang, Lin; Huang, Peng; Zheng, Guoyan

doi:10.1097/md.0000000000005186

Cited by 41 publications

(24 citation statements)

References 21 publications

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“…Some authors have also reported good clinical results of endoscopic lumbar unilateral decompression for lateral recess stenosis through transforaminal approach [17,21,[28][29]. However, transforaminal unilateral decompression is often insu cient for CLSS.…”

Section: Discussionmentioning

confidence: 99%

Degenerative central lumbar spinal stenosis: Is endoscopic decompression through bilateral transforaminal approach sufficient?

Zhang

Kong

Yan

et al. 2020

Preprint

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Background: At present, few percutaneous endoscopic transforaminal decompression surgery has been reported to solve central lumbar spinal stenosis (CLSS). Whether endoscopic decompression through lateral transforaminal approach decompression is sufficient for degenerative CLSS.Methods: This retrospective study included 47 cases of CLSS patients who underwent percutaneous endoscopic decompression through a bilateral transforaminal approach. Clinical outcomes such as ODI, back and leg VAS, the Macnab criteria were evaluated. Surgical results including operative time, postoperative hospital stay, recurrence, and surgical complications were also studied. Radiologically, lumbar stability was assessed and lumbar dural sac dimension was compared preoperatively and postoperatively.Results：All 47 patients were followed up. The average follow-up period was 24.5 months. The average operation time was 116 minutes. The mean VAS of leg and back pain, and the mean ODI improved from 7.81, 2.53, and 77.03% at baseline to a final 1.94 (P=0.00), 2.47 (P=0.71), and 19.40 % (P=0.00), respectively. According to the Macnab criteria, 97.9% of patients achieved excellent and good results. There were 2 cases of dura tear and 3 cases of transient postoperative dysthesia. The cross sectional area of the dural sac was significantly enlargement at the last fellow up (74.28±13.08 mm2 vs.104.91±12.40 mm2, P=0.00).Conclusions: Except for the main pathogenic factors on the dorsal side of the dural sac, percutaneous endoscopic decompression through a bilateral transforaminal approach is sufficient for CLSS. It is a feasible, safe, and clinically effective minimally invasive procedure.

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Section: Discussionmentioning

confidence: 99%

Degenerative central lumbar spinal stenosis: Is endoscopic decompression through bilateral transforaminal approach sufficient?

Zhang

Kong

Yan

et al. 2020

Preprint

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“…Many studies have reported satisfactory results of patients with LRS following TESSYS with endoscopic drill system [12,22]. In order to achieve effective dorsal decompression of LRS , the distance from the midline to the skin entry point is farther than that of a typical transforaminal approach in these studies.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of TESSYS and TESSYS-ISEE Approach on Treatment of Lateral Recess Stenosis: A Comparison Study

Xiong²,

Huang³

et al. 2020

Preprint

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Background: Lateral recess stenosis (LRS) is a common degenerative disease in the elderly. Since the rise of comorbidity is associated with the increasing age, the percutaneous endoscopic lumbar decompression is advocated. The objective of this study was to compare the clinical outcomes of percutaneous endoscopic lumbar decompression in LRS via TESSYS or TESSYS-ISEE approach. Methods: A total of 45 and 42 consecutive patients with limp or radiculopathy symptoms underwent percutaneous endoscopic lumbar decompression using transforaminal endoscopic spine system (TESSYS) and TESSYS-ISEE, respectively. The radiation exposure and operation time, time to return to work, and complications were compared between two groups. Their clinical outcomes were evaluated with visual analogue scale (VAS) leg pain score, VAS back pain score, Oswestry Disability Index (ODI) and Modified MacNab’s criteria. Results: The average values of radiation exposure and operative time in TESSYS group were significantly higher than those in TESSYS-ISEE group (P<0.05). The postoperative VAS and ODI scores in both groups were significantly improved compared with before the operation (P<0.05). In addition, the VAS score of the leg and ODI score in the TESSYS-ISEE group were significantly lower than those in TESSYS group at 1 week follow-up (P<0.05). The good-to-excellent rates of the TESSYS and TESSYS-ISEE group were 88.89 and 90.48%, respectively, whereas the complication occurrence rates were 6.67 and 4.76% in TESSYS and TESSYS-ISEE groups, respectively. Conclusions: TESSYS-ISEE can be applied to treat LRS safely and effectively with short radiation exposure and operation time. This approach was comparable to the TESSYS approach with improved VAS leg pain and ODI score in short period after operation. However, potential complications and risks still needs to be considered.

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“…All these causes pressurize the nerve root which leads to the disease. The purpose of intervention in this disease is to decrease the pressure and tension applied on the nerve by removing the source of pressure [6][7][8][9][10][11][12]. The percutaneous foraminotomy introduced in this case report is a newly developed minimally invasive device that reduces pressure on the nerve root as well as the blood vessels in the neural canal.…”

Section: Discussionmentioning

confidence: 99%

Application of percutaneous foraminotomy with a specially designed drill tip for foraminal stenosis patient - A case report -

Choo

Sim

2018

Anesth Pain Med

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Degenerative diseases are rapidly increasing all over the world with the increase of the elderly population.Spinal stenosis is one of the common degenerative disease and various treatment methods have been applied to treat this disease and control the pain. Currently, diverse, non-operative interventions used for the treatment of spinal stenosis in addition to novel interventional techniques and tools are rapidly [1].These interventions are alternative methods to patients who are not responsive to conservative treatment like physical therapy, medications and epidural steroid injections. Furthermore, these can be useful treatment options to patients who refuse surgery.Leg pain while walking, which is relieved when the patient squats, sits, or rests, is a typical symptom of foraminal stenosis. This suggests that the pressure on the nerve root is an important factor of disease pathogenesis and that foraminal decompression is central to the treatment of foraminal steno-The purpose of this report is to introduce a new therapeutic intervention for foraminal stenosis-percutaneous foraminotomy with the use of the Claudicare system. Percutaneous foraminotomy is a procedure that indirectly decompresses the foramen, and is performed in the safe area inside the neural foramen, which is Kambin's triangle. CASE REPORTA 77-year-old 164 cm, 62 kg previously healthy Asian man This case report describes a new method of pain management intervention: percutaneous foraminotomy using the Claudicare system (Seawon Meditech, Korea). In this case, a 77-year-old Asian man visited the hospital with motor weakness in his left foot. He was diagnosed with L4-5 grade three foraminal stenosis using Magnetic Resonance Imaging on both sides. A left L4-5 foraminal decompression was performed using percutaneous foraminotomy. The patient revisited the hospital after 17 months because the same symptoms recurred in his right foot. We observed that the symptoms on the left foot had disappeared completely. We confirmed the lesion on the right side and the postoperative change on the left side on the magnetic resonance imaging (MRI) image. Both the pre-and postoperative MRI images were compared by measuring the dimensions of the foraminal area (28.12 mm 2 vs. 38.58 mm 2 , repectively). T1W images showed signs of increased epidural soft tissue after percutaneous foraminotomy.

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Percutaneous endoscopic transforaminal lumbar spinal canal decompression for lumbar spinal stenosis

Cited by 41 publications

References 21 publications

Degenerative central lumbar spinal stenosis: Is endoscopic decompression through bilateral transforaminal approach sufficient?

Degenerative central lumbar spinal stenosis: Is endoscopic decompression through bilateral transforaminal approach sufficient?

Clinical Outcomes of TESSYS and TESSYS-ISEE Approach on Treatment of Lateral Recess Stenosis: A Comparison Study

Application of percutaneous foraminotomy with a specially designed drill tip for foraminal stenosis patient - A case report -

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