Sufficient Lumbar Lateral Recess Decompression Acquired by Undercutting “Superior Articular Process Neck” Plus Intervertebral Disk Annuloplasty in Percutaneous Transforaminal Endoscopic Surgery

Liu, Xinchun; Peng, Yunfei; Pei, Lei; Zhu, Yue

doi:10.12659/msm.921119

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…Lateral recess stenosis (LRS) is a common type of lumbar spinal stenosis in elderly individuals[ 1 , 2 ]. In spinal anatomy, the lateral recess is the outermost region of the spinal canal bordered laterally by the pedicle, posteriorly by the superior articular facet and ligamentum flavum, and anteriorly by the vertebral body, endplate, and disc margin[ 3 ], which is considered stenotic when the anteroposterior measurement is < 4 mm[ 4 ]. Due to the close proximity within the spinal canal, stenosis in this region always leads to low back pain, numbness, neurogenic claudication and even urination-defecation impairment[ 2 ], which often affect mobility and walking ability, leading to a reduction in patients’ quality of life[ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Novel approach of ultrasound-guided lateral recess block for a patient with lateral recess stenosis: A case report

Yang,

Li,

2024

World J Clin Cases

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BACKGROUND Ultrasound guide technology, which can provide real-time visualization of the needle tip and tissues and avoid many adverse events, is widely used in minimally invasive therapy. However, the studies on ultrasound-guided Lateral recess block (LRB) are limited, this is probably because there is no recognized standard method for ultrasound scanning. This study aimed to evaluate the effect of ultrasound-guided LRB in patients with lateral recess stenosis (LRS). CASE SUMMARY A 65-year-old patient complained of low back pain accompanied occasionally by pain and numbness in the left lower limb. Physical examination showed tenderness on the spinous process and paraspinal muscles from L1 to S1, extensor hallucis longus and tibialis anterior weakness (muscle strength: 4−), and a positive straight leg raising test in the left lower limb (60°). Magnetic resonance imaging showed L4–L5 disc degeneration with left LRS and nerve root entrapment. Subsequently, the patient was diagnosed with LRS. This patient was treated with a novel ultrasound-guided LRB approach. The patient’s symptoms significantly improved without any complications at 1 wk postoperatively and at the 3-month follow-up. CONCLUSION This is the first report on the LRS treatment with ultrasound-guided LRB from the contralateral spinous process along the inner side of the articular process by out-plane technique. Further studies are expected to investigate the efficacy and safety of ultrasound-guided LRB for patients with LRS.

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Section: Introductionmentioning

confidence: 99%

Novel approach of ultrasound-guided lateral recess block for a patient with lateral recess stenosis: A case report

Yang,

Li,

2024

World J Clin Cases

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Complications and Management of Endoscopic Spinal Surgery

Lee

2023

Neurospine

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In the past, the use of endoscopic spine surgery was limited to intervertebral discectomy; however, it has recently become possible to treat various spinal degenerative diseases, such as spinal stenosis and foraminal stenosis, and the treatment range has also expanded from the lumbar spine to the cervical and thoracic regions. However, as endoscopic spine surgery develops and its indications widen, more diverse and advanced surgical techniques are being introduced, and the complications of endoscopic spine surgery are also increasing accordingly. We searched the PubMed/MEDLINE databases to identify articles on endoscopic spinal surgery, and key words were set as “endoscopic spinal surgery,” “endoscopic cervical foramoinotomy,” “PECD,” “percutaneous transforaminal discectomy,” “percutaneous endoscopic interlaminar discectomy,” “PELD,” “PETD,” “PEID,” “YESS” and “TESSYS.” We analyzed the evidence level and classified the prescribed complications according to the literature. Endoscopic lumbar surgery was divided into full endoscopic interlaminar and transforaminal approaches and a unilateral biportal approach. We performed a comprehensive review of available literature on complications of endoscopic spinal surgery. This study particularly focused on the prevention of complications. Regardless of the surgical methods, the most common complications related to endoscopic spinal surgery include dural tears and perioperative hematoma. transient dysesthesia, nerve root injury and recurrence. However, Endoscopic spinal surgery, including full endoscopic transforaminal and interlaminar and unilateral biportal approaches, is a safe and effective a treatment for lumbar as well as cervical and thoracic spinal diseases such as disc herniation, lumbar spinal stenosis, foraminal stenosis and recurrent disc herniation.

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Full-Endoscopic Transforaminal Decompression with Modified Reaming Technique on Lateral Recess Stenosis: Outcomes of 155 Cases and Five Years’ Experience. A Case Series Study

Chung,

Su,

et al. 2024

Preprint

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Objective: Lateral recess stenosis (LRS) is a degenerative condition which caused by bulging disc, hyperplasia of superior articular process and hypertrophy of ligament flavum. The advancement of transforaminal endoscopic lumbar approaches provides effective treatment not only for migrated herniation but also for stenosis. We outlined a modified non-sequential foraminoplasty technique utilizing a trephine, and conducted a comprehensive review of our cases to demonstrate safety and efficacy of the procedure. Methods: Patients with lumbar radiculopathy refractory to conservative treatment, diagnosed with magnetic resonance imaging (MRI) and diagnostic root blocks, and underwent full endoscopic transforaminal decompression with the modified non-sequential foraminoplasty technique between April 2017 to September 2022 were included. Those with multiple level stenosis, previous surgery at the same level, unstable spondylolisthesis, lumbar herniated disc without stenosis, infection, fracture, or tumor were excluded. The study recorded the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Modified Macnab criteria, as well as intra- and postoperative complications. Results:. 155 patients were included in the study. Clinical and postoperative outcomes revealed significantly lower back and leg visual analog scale scores, as well as Oswestry Disability Index scores at various postoperative time points compared to preoperative values (P < 0.01) At the final follow-up, the modified MacNab criteria were rated as follows: excellent in 65 patients (41.9%), good in 60 patients (38.7%), fair in 2 patients (1.2%), and poor in 28 patients (18.0%). Conclusions: Full endoscopic transforaminal decompression using modified non-sequential foraminoplasty technique is an effective and safe treatment for lumbar lateral recess stenosis.

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Sufficient Lumbar Lateral Recess Decompression Acquired by Undercutting “Superior Articular Process Neck” Plus Intervertebral Disk Annuloplasty in Percutaneous Transforaminal Endoscopic Surgery

Cited by 3 publications

References 25 publications

Novel approach of ultrasound-guided lateral recess block for a patient with lateral recess stenosis: A case report

Novel approach of ultrasound-guided lateral recess block for a patient with lateral recess stenosis: A case report

Complications and Management of Endoscopic Spinal Surgery

Full-Endoscopic Transforaminal Decompression with Modified Reaming Technique on Lateral Recess Stenosis: Outcomes of 155 Cases and Five Years’ Experience. A Case Series Study

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