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. 2020 Jul 15;45(14):E871-E877.
doi: 10.1097/BRS.0000000000003478.

Unilateral Laminectomy by Endoscopy in Central Lumbar Canal Spinal Stenosis: Technical Note and Early Outcomes

Fenglong Sun  1 , Qingchen Liang  1 , Ming Yan  2 , Hongqing Wang  1 , Zuyao Liu  1 , Fu Li  1 , Jie Dong  1 , Tiejun Liu  3
Affiliations

Unilateral Laminectomy by Endoscopy in Central Lumbar Canal Spinal Stenosis: Technical Note and Early Outcomes

Fenglong Sun et al. Spine (Phila Pa 1976). .

Abstract

Study design: Retrospective study.

Objective: To evaluate the outcomes and safety of endoscopic laminectomy for central lumbar canal spinal stenosis.

Summary of background data: .: Spinal endoscopy is mostly used in the treatment of lumbar disc herniation, while endoscopic laminectomy for lumbar spinal stenosis is rarely reported.

Methods: From January 2016 to June 2017, 38 patients with central lumbar canal spinal stenosis were treated with endoscopic laminectomy. Clinical symptoms were evaluated at 1, 3, 6, and 12 months and the last follow-up after surgery. Functional outcomes were assessed by using the Japanese Orthopedic Association Scores (JOA) and Oswestry Disability Index (ODI). The decompression effect was assessed by using the dural sac cross-sectional area (DSCA). Lumbar stability was evaluated using lumbar range of motion (ROM), ventral intervertebral space height (VH), and dorsal intervertebral space height (DH).

Results: The mean age of the cases was 60.8 years, the mean operation time was 66.3 minutes, the blood loss was 38.8 mL, and the length of incision was 19.6 mm. The mean time in bed was 22.3 hours, and the mean hospital stay was 8.8 days. JOA scores were improved from 10.9 to 24.1 (P < 0.05), ODI scores were improved from 79.0 to 27.9 (P < 0.05), DSCA was improved from 55.7 to 109.5 mm (P < 0.05), ROM scores were improved from 5.6° to 5.7° (P < 0.05), and DH scores were reduced from 6.6 to 6.5 mm (P < 0.05). There was no significant difference in VH before and after operation (P > 0.05). There were no serious complications during the follow-ups.

Conclusion: Endoscopic laminectomy had the advantage of a wider view, which was effective, safe, and less invasive for lumbar spinal stenosis.

Level of evidence: 5.

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Figures

Figure 1
Figure 1
Endoscopic spine system (A, B). Endoscope (a), duck-mouth protective cannula (b), and trephines (c).
Figure 2
Figure 2
Localization and puncture in a female (left). The entry point was determined by C-arm fluoroscopy, a spinal needle was inserted into 1/3 of the superior articular process, the working channel was introduced (A, B).
Figure 3
Figure 3
Diagram of decompression effects and lumbar stability. Preoperative measurement of DSCA (A); Postoperative measurement of DSCA (B); measurement of intervertebral space height, including VH and DH (C); measurement of Cobb Angle by X-ray at the flexion-extension position (D). DH indicates dorsal intervertebral space height; DSCA, dural sac cross-sectional area; VH, ventral intervertebral space height.
See this image and copyright information in PMC

References

    1. Kreiner DS, Shaffer WO, Baisden JL, et al. An evidence-based clinical guideline for the diagnosis and treatment of degenerativelumbar spinal stenosis (update). Spine J 2013; 13:734–743. - PubMed
    1. Aizawa T, Kokubun S, Ozawa H, et al. Increasing incidence of degenerative spinal diseases in Japan during 25 years: The Registration System of Spinal Surgery in Tohoku University Spine Society. Tohoku J Exp Med 2016; 238:153–163. - PubMed
    1. Yabuki S, Fukumori N, Takegami M, et al. Prevalence of lumbar spinal stenosis, using the diagnostic support tool, and correlated factors in Japan: a population-based study. J Orthop Sci 2013; 18:893–900. - PMC - PubMed
    1. Barz T, Melloh M, Staub LP, et al. Increased intraoperative epidural pressure in lumbar spinal stenosis patients with a positivenerve root sedimentation sign. Eur Spine J 2014; 23:985–990. - PubMed
    1. Mobbs RJ, Li J, Sivabalan P, et al. Outcomes after decompressive laminectomy for lumbar spinal stenosis: comparison between minimally invasive unilateral laminectomy for bilateral decompression and open laminectomy: clinical article. J Neurosurg Spine 2014; 21:179–186. - PubMed