Using a percutaneous spinal endoscopy unilateral posterior interlaminar approach to perform bilateral decompression for patients with lumbar lateral recess stenosis

Abstract

Objective: To report the clinical and radiographic outcomes of 47 patients with bilateral symptomatic lumbar lateral recess stenosis (LLRS) treated with percutaneous spinal endoscopy (PSE) via a unilateral posterior interlaminar approach with bilateral decompression.

Methods: Forty-seven patients with single-level LLRS and bilateral symptoms who underwent PSE using a unilateral posterior interlaminar approach to perform bilateral decompression between May 2014 and June 2016 were reviewed retrospectively. Surgical-related data were collected, and clinical efficacy was evaluated using the Visual Analogue Scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and the single continuous walking distance (SCWD) without pain at preoperative and postoperative time points. Patient satisfaction was evaluated by modified MacNab criteria at the one-year postoperative time point.

Results: All patients displayed improvements in clinical symptoms after surgery and were discharged the day of surgery. The mean operation time and blood loss were 91.17 ± 16.81 min and 13.53 ± 4.94 mL, respectively. At a mean follow-up of 18.33 ± 4.16 months, none of the patients required reoperation, while 6 of 47 patients experienced complications. VAS scores for back and leg pain, ODI, and SCWD were significantly improved at all postoperative time points compared with the preoperative values. Satisfactory (excellent or good) results were demonstrated in 44 of 47 patients (93.6%) at the one-year postoperative time point.

Conclusions: The percutaneous spinal endoscopic technique via a unilateral posterior interlaminar approach for performing bilateral decompression is a less invasive, effective and safe surgery and can be considered an alternative option for treating patients with bilateral symptomatic LLRS.

Keywords: Bilateral decompression; Lumbar lateral recess stenosis; Minimally invasive spinal surgery; Percutaneous spinal endoscopy; Unilateral posterior interlaminar approach.