scholarly journals Comment on “Efficacy and safety of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar spinal stenosis combined with osteoporosis”

2021 ◽  
Vol 67 (10) ◽  
pp. 1517-1517
Author(s):  
Jie Ding ◽  
Qiong-mei Han
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Efficacy And Safety ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Lumbar Spinal

scholarly journals Efficacy and safety of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar spinal stenosis combined with osteoporosis

2019 ◽  
Vol 65 (6) ◽  
pp. 779-785
Author(s):  
Xiaobin Gu ◽  
Wenhui Zhu ◽  
Haiyi He ◽  
Zili Wang ◽  
Shaolong Ding ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Adverse Reactions ◽  
Leg Pain ◽  
Control Group ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Lumbar Spinal

SUMMARY OBJECTIVE: To investigate the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar spinal stenosis (LSS) combined with osteoporosis. METHODS: Eighty patients with LSS combined with osteoporosis were divided into a control and PTED group, which received conventional transforaminal lumbar interbody fusion and PTED, respectively. The surgical indications, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores, bone mineral density (BMD), and adverse reactions were observed. RESULTS: Compared with the control group, in the PTED group, the operation time, bleeding loss and hospitalization duration, incision VAS scores at postoperative 12, 24 and 48 h and lumbar and leg pain VAS and lumbar ODI scores on postoperative 6 months were significantly decreased (P < 0.01), and the lumbar JOA score on postoperative 6 months was significantly increased (P < 0.05). There was no significant difference in BMD between two groups (P > 0.05). Compared with the control group, in the PTED group, the total effective rate was significantly higher (P < 0.05), and the incidence of adverse reactions was significantly lower (P < 0.05). CONCLUSIONS: PTED is safe and effective in the treatment of LSS combined with osteoporosis.

Efficacy of percutaneous transforaminal endoscopic discectomy unilateral and bilateral approach for bilateral decompression in treatment of degenerative lumbar spinal stenosis and their effects on quality of life

2021 ◽  
Vol 7 (6) ◽  
pp. 6540-6554
Author(s):  
Xuanhuang Chen ◽  
Xiaoqiang Gao ◽  
Haibin Lin ◽  
Hanhua Cai ◽  
Feng Zheng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Stenosis ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Bilateral Approach ◽  
Group A ◽  
Group B ◽  
Lumbar Spinal

This study aimed to explore the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) unilateral and bilateral approach for bilateral decompression in the treatment of degenerative lumbar spinal stenosis (DLSS) and their effects on quality of life. Altogether 119 patients with DLSS admitted to our hospital from May 2012 to February 2014 were enrolled in this study. Patients in Group A (62 cases) were treated with PTED bilateral approach for bilateral decompression, while those in Group B (57 cases) were treated with PTED unilateral approach for bilateral decompression. The therapeutic effect and incidence of complications in the two groups were observed. Visual Analogue Scale (VAS) was used to assess the pain degree of the lower limbs. Oswestry Disability Index (ODI) was used to assess the improvement of neurological function. 36-ltem Short Form Health Survey (SF-36) developed by the Institute of Medicine was used to assess the quality of life. There were no significant differences between Group A and Group B in operative time, intraoperative blood loss, hospitalization time, the effective rate of treatment, and the incidence of complications (P>0.05). The recovery time of lumbar function in Group A was significantly shorter than that in Group B (P<0.01). VAS and ODI scores at 1, 3, and 6 months after operation in Group A were significantly lower than those in Group B (P<0.05). The scores of general health (GH), bodily pain (BP), social function (SF), vitality (VT), and mental health (MH) at 6 months after operation in Group A were significantly higher than those in Group B (P<0.05). In conclusion, PTED bilateral approach for bilateral decompression was effective in the treatment of patients with DLSS. It can promote the recovery of their lumbar function and neurological function, and improve their quality of life.

scholarly journals Efficacy and safety of unilateral biportal endoscopy compared with microscopic decompression in the treatment of lumbar spinal stenosis

Medicine ◽  
2021 ◽  
Vol 100 (50) ◽  
pp. e27970
Author(s):  
Chuntao Li ◽  
Fei Ju ◽  
Wenyi Li ◽  
Shangju Gao ◽  
Can Cao ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Efficacy And Safety ◽  
Lumbar Spinal

scholarly journals RADIOFREQUENCY FACILITATED MANUAL SEMI-ENDOSCOPIC DISCECTOMY UTILIZING THE DISC FX® SYSTEM IN THE TREATMENT OF DISC-PREDOMINATE LUMBAR SPINAL STENOSIS

2018 ◽  
pp. 173-181
Author(s):  
George J. Arcos
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Central Canal ◽  
Leg Pain ◽  
Radiographic Evidence ◽  
Canal Stenosis ◽  
Canal Diameter ◽  
Endoscopic Discectomy ◽  
Lumbar Spinal

Background: Lumbar spinal stenosis (LSS) occurs with increasing prevalence in the elderly population. The American Academy of Orthopedic Surgeons has estimated that by 2021, 2.4 million adults in the United States (8-11% of the population) will be affected by this condition. Surgical options for LSS are being performed with increased frequency, high cost, and substantial risk of life-threatening complications. While nonsurgical treatment options for LSS are available, they are limited by patient selection (ligamentum flavum hypertrophy) or high rates of reoperation (Interspinous process spacer devices). This study is the first to suggest a minimally invasive treatment option for disc-predominate lumbar central canal stenosis. Objectives: To evaluate the clinical efficacy of radiofrequency facilitated manual semi-endoscopic discectomy utilizing the Disc FX® system in the treatment of disc-predominate lumbar spinal stenosis. Study Design: Single center, prospective, observational study. Setting: Multi-specialty private practice clinic. The Medical Group of South Florida, Jupiter, FL. Methods: This study involved 6 patients with disc-predominant lumbar central spinal stenosis. All patients were treated with the Disc FX® system. Radiographic evidence of central lumbar stenosis was confirmed by measurement of minimum AP canal diameter (mm) performed by 1 board-certified neuroradiologist. Inclusion criteria included absence of lumbar surgery, physical therapy within the previous 6 months, failure of epidural steroid injections (3) within the previous 8 months, spondylolisthesis limited to Grade I, disc height > 50%, presence of low back axial pain + leg pain exacerbated by walking, and relieved with sitting or forward flexion, absence of dermatomal radicular leg pain, radiographic evidence of disc displacement > 4 mm from disc endplate. Zurich claudication (symptom severity and physical function scale was administered 1 week preoperatively, and again 6 months postoperatively. There were no patients lost to follow up. Results: All patients in the study demonstrated moderate-severe or severe central canal stenosis, with an average AP canal diameter of 6.63 mm for all treated disc levels and 5.5 mm for the most severe levels. There was a mean improvement of 57% in a symptom severity scale and 56% in the physical function scale at 6 months. This exceeds the improvement reported with interspinous spacer devices. Limitations: Limitations include very small sample size, observational design, non-randomization, absence of share controls, short follow-up period. Conclusion: For patients suffering from discpredominant lumbar spinal stenosis, The Disc FX® System provides an effective, low-cost alternative to surgical intervention. Key words: Spinal, stenosis, claudication, disc, Disc FX®, operative, minimally invasive, Zürich claudication score

scholarly journals Evaluation of the efficacy and safety of conventional and biportal endoscopic decompressive laminectomy in patients with lumbar spinal stenosis (ENDO-B trial): a protocol for a prospective, randomized, assessor-blind, multicenter trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hyun-Jin Park ◽  
Sang-Min Park ◽  
Kwang-Sup Song ◽  
Ho-Joong Kim ◽  
Si-Young Park ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Controlled Trial ◽  
Small Sample ◽  
Endoscopic Technique ◽  
Efficacy And Safety ◽  
Research Information ◽  
Level Of Evidence ◽  
Decompressive Laminectomy ◽  
Lumbar Spinal

Abstract Background Recent studies on biportal endoscopic spine surgery in patients with lumbar spinal stenosis have reported good clinical results. However, these studies have been limited by the small sample sizes and use of a retrospective study design. Therefore, we aim to compare the efficacy and safety of biportal endoscopic decompressive laminectomy with those of conventional decompressive laminectomy in a multicenter, prospective, randomized controlled trial. Methods This study will include 120 patients (60 per group, aged 20–80 years) with 1- or 2-level lumbar spinal stenosis, who will be recruited from six hospitals. The study will be conducted from July 2021 to December 2024. The primary outcome (Oswestry Disability Index at 12 months after surgery) will be evaluated through a modified intention-to-treat method. The secondary outcomes will include the following: visual analog scale score for low back and lower extremity radiating pain, EuroQol 5-dimensions score, surgery satisfaction, walking time, postoperative return to daily life period, postoperative surgical scars, and some surgery-related variables. Radiographic outcomes will be analyzed using magnetic resonance imaging or computed tomography. All outcomes will be evaluated before the surgery and at 2 weeks, 3 months, 6 months, and 12 months postoperatively. This protocol adheres to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines for reporting of clinical trial protocols. Discussion It is hypothesized that the efficacy and safety of biportal endoscopic and conventional decompressive laminectomy will be comparable in patients with lumbar spinal stenosis. The results of this trial will provide a high level of evidence for the efficacy and safety of the biportal endoscopic technique in patients with lumbar spinal stenosis and facilitate the development of clinical practice guidelines. Furthermore, the results of this study may indicate the feasibility of the biportal endoscopic technique for other types of spinal surgery. Trial registration The ENDO-B trial is registered at Clinical Research Information Service (CRIS, cris.nih.go.kr) (KCT0006057; April 52,021).

scholarly journals Comparative efficacy and safety of surgical and invasive treatments for adults with degenerative lumbar spinal stenosis: protocol for a network meta-analysis and systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024752
Author(s):  
Lingxiao Chen ◽  
Paulo H Ferreira ◽  
Paula R Beckenkamp ◽  
Manuela L Ferreira
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Invasive Procedures ◽  
Comparative Efficacy ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Lumbar Spinal

IntroductionSurgical and invasive procedures are widely used in adults with degenerative lumbar spinal stenosis when conservative treatments fail. However, little is known about the comparative efficacy and safety of these interventions. To address this, we will perform a network meta-analysis (NMA) and systematic review to compare the efficacy and safety of surgical and invasive procedures for adults with degenerative lumbar spinal stenosis.Methods and analysisWe will include randomised controlled trials assessing surgical and invasive treatments for adults with degenerative lumbar spinal stenosis. We will search AMED, CINAHL, EMBASE, the Cochrane Library and MEDLINE. Only English studies will be included and no restriction will be set for publication status. For efficacy, our primary outcome will be physical function. Secondary outcomes will include pain intensity, health-related quality of life, global impression of recovery, work absenteeism and mobility. For safety, our primary outcome will be all-cause mortality. Secondary outcomes will include adverse events (number of events or number of people with an event) and treatment withdrawal due to adverse effect. Two reviewers will independently select studies, extract data and assess the risk of bias (Revised Cochrane risk-of-bias tool for randomized trials) of included studies. The quality of the evidence will be evaluated through the Grading of Recommendations Assessment, Development and Evaluation framework. Random-effects NMA will be performed to combine all the evidence under the frequentist framework and the ranking results will be presented through the surface under the cumulative ranking curve and mean rank. All analyses will be performed in Stata and R.Ethics and disseminationNo ethical approval is required. The research will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018094180.

scholarly journals Efficacy of Percutaneous Transforaminal Endoscopic Discectomy Unilateral and Bilateral Approach for Bilateral Decompression in Treatment of Degenerative Lumbar Spinal Stenosis and Their Effects on Quality of Life

2021 ◽  
Author(s):  
Xianbin Cai ◽  
Haibin Lin ◽  
Xuanhuang Chen ◽  
Hanhua Cai ◽  
Feng Zheng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Stenosis ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Bilateral Approach ◽  
Group A ◽  
Group B ◽  
Lumbar Spinal

Abstract This study aimed to explore the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) unilateral and bilateral approach for bilateral decompression in the treatment of degenerative lumbar spinal stenosis (DLSS) and their effects on quality of life. Altogether 119 patients with DLSS admitted to our hospital from May 2012 to February 2014 were enrolled in this study. Patients in Group A (62 cases) were treated with PTED bilateral approach for bilateral decompression, while those in Group B (57 cases) were treated with PTED unilateral approach for bilateral decompression. The therapeutic effect and incidence of complications in the two groups were observed. Visual Analogue Scale (VAS) was used to assess the pain degree of the lower limbs. Oswestry Disability Index (ODI) was used to assess the improvement of neurological function. 36-Item Short Form Health Survey (SF-36) developed by the Institute of Medicine was used to assess the quality of life. There were no significant differences between Group A and Group B in operative time, intraoperative blood loss, hospitalization time, the effective rate of treatment, and the incidence of complications (P>0.05). The recovery time of lumbar function in Group A was significantly shorter than that in Group B (P<0.01). VAS and ODI scores at 1, 3, and 6 months after operation in Group A were significantly lower than those in Group B (P<0.05). The scores of general health (GH), bodily pain (BP), social function (SF), vitality (VT), and mental health (MH) at 6 months after operation in Group A were significantly higher than those in Group B (P<0.05). In conclusion, PTED bilateral approach for bilateral decompression was effective in the treatment of patients with DLSS. It can promote the recovery of their lumbar function and neurological function, and improve their quality of life.

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