Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis

Abstract

<jats:p content-type="fine-print"><jats:italic>Object.</jats:italic> The authors applied the technique of microendoscopic discectomy to posterior decompression procedures for lumbar spinal stenosis. The purpose of this study was to determine the feasibility of using an endoscopic technique to treat lumbar spinal stenosis and to evaluate the clinical and radiographic results of microendoscopic posterior decompression (MEPD).</jats:p> <jats:p content-type="fine-print"><jats:italic>Methods.</jats:italic> Microendoscopic posterior decompression, which involves a unilateral endoscopic approach for bilateral decompression, was performed in 47 patients. Clinical and radiographic/neuroimaging results were evaluated during the follow-up period (minimum duration 1 year). The clinical results were compared with those of the conventional laminotomy. Radiographic instability and the degree of surgical invasion of the facet joints were evaluated. In a control a group of 29 patients open laminotomy was performed.</jats:p> <jats:p content-type="fine-print">The clinical outcome was evaluated in 44 patients. The mean follow-up duration was 22 months. The mean rate of improvement was 72% based on the Japanese Orthopaedic Association score, and good results were obtained in 38 patients. Although the rate of morbidity decreased in the MEPD group, the incidence of complication was slightly higher. Effective decompression was demonstrated in the majority of the patients by using magnetic resonance imaging. Radiographic instability appeared in one patient postoperatively, and based on computerized tomography scanning, a tendency toward invasion of the facet joint on the approach side was noted.</jats:p> <jats:p content-type="fine-print"><jats:italic>Conclusions.</jats:italic> Microendoscopic posterior decompression is a minimally invasive procedure and is as useful as other conventional procedures in treating lumbar spinal stenosis; however, a few technical problems remain to be solved.</jats:p>

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

“…In line with Ikuta et al, 21 and Pao et al, 38 postoperative neural complications in form of transient dysesthesia were observed in 7.9% of patients however dysesthesia was mild and resolved gradually. The rationale of MEDL is to attempt maximal preservation the facet joint, bony anatomy, ligamentous structures and paravertebral muscles in order to maintain spinal stability; however fractures can occur to spinous process.…”

“…In 2 similar studies, 80%, 81% patients obtained good and excellent results. 21,38 Regardless of short follow-up period in this study which precludes adequate evaluation of potential lumbar canal restenosis and long-term symptomatic deterioration as described for classic laminectomy 17 , our patients reported an overall symptomatic improvement rate of 78% for back pain, 86.3% for leg pain based on VAS scores at 3 months postoperatively. Our results are analogous to those documented by Khoo and Fessler 24 who reported a symptomatic improvement of 84%, 90% for back and leg pain respectively.…”

“…12,34 Despite technical skills that ought to be gained and intra-procedurally met technical difficulties; microendoscopic unilateral laminotomy for bilateral decompression is coupled with various benefits like maintenance of spinal stability, better patient satisfaction and relatively low rate of complication. 20,21,41 The purpose of this study is to investigate the efficacy of the technique in a large cohort having single and multiple LCS and also to portray its safety, clinical and functional outcome through short-term follow-up.…”

Development of percutaneously insertable/removable interspinous process spacer for treatment of posture-dependent lumbar spinal-canal stenosis: preclinical feasibility study using porcine model

“…Recently, progress has been made in minimizing the surgical approach using, for example, microscope or endoscope [5,7,14]. Another approach has been to insert an IPS to maintain segmental flexion or prevent extension, thereby indirectly decompressing nerve tissues.…”

A study on functional and radiological outcome in precontoured locking plate fixation for displaced lateral end of clavicle fractures

“…Patient disability determined with the help of Japanese Orthopaedics Association (JOA) Score All routine blood investigations required for purpose of anaesthetic fitness purpose were done in all patients. Basic Principles of Decompression Technique 6,7,8,9,10,11,12 In patient positioning: the patient is given the prone position with the lumbar region in hyperflexion. Interlaminar distance opens up so decompression can be done safely.…”