scholarly journals A comparison study of percutaneous endoscopic decompression and posterior decompressive laminectomy in the treatment of thoracic spinal stenosis

2020 ◽  
Author(s):  
Xiao-Kang Cheng ◽  
Fu-Cheng Bian ◽  
Zhao-Yu Liu ◽  
Feng-Kai Yang ◽  
Bin Chen

Abstract Background: Percutaneous endoscopic decompression (PED) is considered a minimally invasive and safe procedure in lumbar degenerative disease. Few authors report the success of PED for thoracic spinal stenosis (TSS) with thoracic myelopathy. The objective of this study was to compare the outcome of PED versus posterior decompressive laminectomy (PDL) for TSS.Methods: We retrospectively reviewed 30 consecutive patients who underwent surgery for single-level TSS from January 1, 2015 to May 1, 2019.These patients were divided into PED (n=16) and PDL(n=14) group. Preoperative demographic characteristics and perioperative outcomes were reviewed. Pre- and postoperative neurological status was evaluated using the modified Japanese Orthopaedic Association (mJOA) score and the recovery rate (RR).Results: The patients’ mean age was 57.3 years (27-76) in PED group and 58.8 years (34-77) in PDL group. No statistical difference was found between two groups with regards to neurological status at pre-operative and final follow-up. The RR in PED group achieved the same improvement as PDL group (87.5% vs 85.7%, P>0.05), while the PED brought advantages in operative time(m) (86.4 vs 132.1, p<0.05), blood loss (mL) (18.21 vs 228.57, p<0.05),drainage volume(mL) (15.5 vs 601.4, p<0.05), and hospital stay (d) (3.6 vs 5.6, p<0.05).Conclusions: Both PED and PDL showed favorable outcome in the treatment of TSS. Besides, PED had advantages in reducing traumatization. In terms of perioperative quality of life, PED could be an efficient supplement to traditional posterior decompressive laminectomy in patients with TSS.

2020 ◽  
Author(s):  
Xiao-Kang Cheng ◽  
Fu-Cheng Bian ◽  
Zhao-Yu Liu ◽  
Feng-Kai Yang ◽  
Bin Chen

Abstract Background: Percutaneous endoscopic decompression (PED) is considered a minimally invasive and safe procedure in lumbar degenerative disease. Few authors report the success of PED for thoracic spinal stenosis (TSS) with thoracic myelopathy. The objective of this study was to compare the outcome of PED versus posterior decompressive laminectomy (PDL) for TSS.Methods: We retrospectively reviewed 30 consecutive patients who underwent surgery for single-level TOLF from January 1, 2015 to May 1, 2019.These patients were divided into PED (n=16) and PDL(n=14) group. Preoperative demographic characteristics and perioperative outcomes were reviewed. Pre- and postoperative neurological status was evaluated using the modified Japanese Orthopaedic Association (mJOA) score and the recovery rate (RR).Results: The patients’ mean age was 57.3 years (27-76) in PED group and 58.8 years (34-77) in PDL group. No statistical difference was found between two groups with regards to neurological status at pre-operative and final follow-up. The RR in PED group achieved the same improvement as PDL group (87.5% vs 85.7%, P>0.05), while the PED brought advantages in operative time(m) (86.4 vs 132.1, p<0.05), blood loss (mL) (18.21 vs 228.57, p<0.05),drainage volume(mL) (15.5 vs 601.4, p<0.05), hospital stay (d) (3.6 vs 5.6, p<0.05).Conclusions: Both PED and PDL showed favorable outcome in the treatment of TSS. Besides, PED had advantages in reducing traumatization. In terms of perioperative quality of life, PED could be an efficient supplement to traditional posterior decompressive laminectomy in patients with TSS.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao-Kang Cheng ◽  
Fu-Cheng Bian ◽  
Zhao-Yu Liu ◽  
Feng-Kai Yang ◽  
Bin Chen

Abstract Background Percutaneous endoscopic decompression (PED) is considered a minimally invasive and safe procedure in lumbar degenerative disease. Few authors report the success of PED for thoracic spinal stenosis (TSS) with thoracic myelopathy. The objective of this study was to compare the outcome of PED versus posterior decompressive laminectomy (PDL) for TSS. Methods We retrospectively reviewed 30 consecutive patients who underwent surgery for single-level TSS from January 1, 2015 to May 1, 2019.These patients were divided into PED (n = 16) and PDL(n = 14) group. Preoperative demographic characteristics and perioperative outcomes were reviewed. Pre- and postoperative neurological status was evaluated using the modified Japanese Orthopaedic Association (mJOA) score and the recovery rate (RR). Results The patients’ mean age was 57.3 years (27–76) in PED group and 58.8 years (34–77) in PDL group. No statistical difference was found between two groups with regards to neurological status at pre-operative and final follow-up. The RR in PED group achieved the same improvement as PDL group (87.5% vs 85.7%, P > 0.05), while the PED brought advantages in operative time(m) (86.4 vs 132.1, p < 0.05), blood loss (mL) (18.21 vs 228.57, p < 0.05),drainage volume(mL) (15.5 vs 601.4, p < 0.05), and hospital stay (d) (3.6 vs 5.6, p < 0.05). Conclusions Both PED and PDL showed favorable outcome in the treatment of TSS. Besides, PED had advantages in reducing traumatization. In terms of perioperative quality of life, PED could be an efficient supplement to traditional posterior decompressive laminectomy in patients with TSS.


2018 ◽  
Vol 27 (S3) ◽  
pp. 465-471 ◽  
Author(s):  
Zhi-Qiang Jia ◽  
Xi-Jing He ◽  
Li-Tao Zhao ◽  
San-Qiang Li

2019 ◽  
Vol 128 ◽  
pp. e504-e512 ◽  
Author(s):  
Chuan Guo ◽  
Daiwen Zhu ◽  
Qingquan Kong ◽  
Lifeng Zhang ◽  
Yu Wang ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hui Wang ◽  
Longjie Wang ◽  
Zhuoran Sun ◽  
Shuai Jiang ◽  
Weishi Li

Abstract Background To assess the incidence and causative factors of unplanned hospital readmission within 90 days after surgical treatment of thoracic spinal stenosis (TSS). Methods Hospital administrative database was queried to identify patients who underwent surgical treatment of TSS from July 2010 through December 2017. All unplanned readmissions within 90 days of discharge were reviewed for causes and the rate of unplanned readmissions was calculated. Patients of unplanned readmission were matched 1:3 to a control cohort without readmission. Results Twenty-one patients (incidence of 1.7 % in 1239 patients) presented unplanned hospital readmission within a 90-day period and enrolled as the study group, 63 non-readmission patients (a proportion of 1: 3) were randomly selected as the control group. Causes of readmission include pseudomeningocele (8 patients; 38 %), CSF leakage combined with poor incision healing (6 patients; 29 %), wound dehiscence (2 patient; 9 %), surgical site infection (2 patients; 9 %), spinal epidural hematoma (1 patient; 5 %), inadequate original surgical decompression (2 patients; 9 %). Mean duration from re-admission to the first surgery was 39.6 ± 28.2 days, most of the patients readmitted at the first 40 days (66.7 %, 14/21 patients). When compared to the non-readmitted patients, diagnosis of OPLL + OFL, circumferential decompression, dural injury, long hospital stay were more to be seen in readmitted patients. Conclusions The incidence of 90-day unplanned readmission after surgical treatment for TSS is 1.7 %, CSF leakage and pseudomeningocele were the most common causes of readmission, the peak period of readmission occurred from 10 to 40 days after surgery, patients should be closely followed up within this period.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037096
Author(s):  
Rong Wang ◽  
Xiuxia Li ◽  
Xiaogang Zhang ◽  
Daping Qin ◽  
Guodong Yang ◽  
...  

IntroductionLumbar spinal stenosis (LSS) is a common lumbar degenerative disease in the elderly, usually requiring surgery if conservative treatment fails. Microscopic decompressive laminectomy (MDL) and percutaneous endoscopic decompressive laminectomy (PEDL) have been widely used to treat LSS. This study aims to provide a protocol for the evaluation and comparison of the efficacy, safety and applicability between MDL and PEDL.Methods and analysisWe will search for randomised controlled trials (RCTs) comparing MDL and PEDL for treating LSS from inception to December 2019 in the following databases: PubMed, The Cochrane Library, Web of Science, Embase and China Biology Medicine. The quality of included studies will be assessed using the risk of bias tool recommended by the Cochrane Handbook 5.2.0. Subsequently, a meta-analysis will be performed using RevMan 5.3 software.Ethics and disseminationGiven the nature of this study, no ethical approval will be required. The protocol will be disseminated via a peer-reviewed journal.PROSPERO registration numberCRD42020164765.


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