Transforaminal Endoscopic Decompression for Lumbar Lateral Recess Stenosis: An Advanced Surgical Technique and Clinical Outcomes

Abstract

Objective: The clinical application of endoscopic techniques for lumbar lateral recess stenosis (LRS) is still challenging. This study aimed to describe a transforaminal endoscopic decompression (TED) technique for LRS and to demonstrate its clinical results.

Methods: Two-year follow-up data were collected from 45 consecutive patients who underwent TED for LRS. Full-scale endoscopic decompression was performed in the dorsal and ventral aspects of the lateral recess with combined partial pediculectomy using an articulating bone burr and endoscopic instruments. Surgical outcomes were evaluated using the Visual Analog Pain Score (VAS), Oswestry Disability Index (ODI), and modified Macnab criteria.

Results: The mean age of the 27 female and 18 male patients was 64.9 years. The mean VAS for leg pain and mean ODI improved from 7.93 and 75.87 at baseline to 1.71 and 17.87, respectively, at 2 years after surgery (P < 0.001 and P < 0.001, respectively). Based on the modified Macnab criteria, excellent or good results were obtained in 86.7% of the patients, and symptomatic improvements were obtained in 97.8%. One patient underwent revision surgery because of incomplete decompression, and 2 experienced transient dysesthesia.

Conclusion: TED with the patient under local anesthesia can be effective for the treatment of LRS, especially for the elderly or patients at a high risk for general anesthesia.

Keywords: Endoscopy; Lateral recess stenosis; Lumbar; Percutaneous; Transforaminal endoscopic decompression.