Techniques of Surgery for Lumbar Spinal Stenosis: A comparative study

Abstract Aim: To compare between classic open surgeries and minimally invasive surgeries in Lumbar Spinal Stenosis. Methods: A comparative descriptive study, involved 117 patients suffering from lumbar canal stenosis, aged between 40-70 years; admitted to department of Neurosurgery from March 2011 till august 2016 in King Fahad Hospital in Saudi Arabia. Study groups are consisted of group A as patients managed with classical laminectomy, group B as patients managed with Endoscopic spinal procedures and group C as patients managed with Microscopic decompression facilitated by the Metrex Tubular System. SPSS was used in data entry and analysis, and ethical considerations taken into consideration and participants filled the required inform consents. Results: Age of particaoncet ranged from 45 - 63 Year, Mean +/- 50. The degenerative canal stenosis with acute disc single level (cauda equina syndrome) was the most common type of lumbar canal stenosis encountered in group A, the unilateral foraminal and lateral recess stenosis without disc prolapse was the most common type of lumbar canal stenosis encountered in group B, while The unilateral foraminal and lateral recess stenosis without disc prolapse was the most common type of lumbar canal stenosis encountered in group C. Classic laminectomy and disectomy used mostly in group A, endoscopic unilateral decompression lamino-foraminotomy without discectomy used mostly in group B and bilateral microscopic laminectomy without discectomy followed by unilateral microscopic lamino-foraminotomy without discectomy used mostly in group C. Mean of operation duration was the highest in both gender of group A, followed by group B, then group C. Unintended durotomy was the most common intra operative complications occurred in the whole study especially in group A. Mean of blood lost was the highest in both gender of group A, followed by group B, then group C. Postop complications in the patients of study Groups was the highest in group A (33.3 %) ,followed by group B (8.5 %) and then group C (2 %). Conclusion: Microscopic decompression facilitated by the Metrex Tubular System is the most effective techniques of Surgery for Lumbar Spinal Stenosis and the least intraoperative and post-operative complications.

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Effect Comparison Of MIS-TLIF Under MED and Quadrant Modes in The Treatment of Lu mbar Spinal Stenosis

Tobacco Regulatory Science ◽

10.18001/trs.7.5.82 ◽

2021 ◽

Vol 7 (5) ◽

pp. 1598-1604

Author(s):

Chen Qi ◽

Xia Chen ◽

Mao Guangfeng ◽

Chen Chuyong ◽

Jin Yongming ◽

...

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Spinal Canal ◽

Spinal Canal Stenosis ◽

Surgical Trauma ◽

Canal Stenosis ◽

Group A ◽

The Difference ◽

Group B ◽

Lumbar Spinal

Background Lumbar spinal stenosis is one of the common causes of low back and leg pain. Lumbar intervertebral disc degeneration leads to the decrease of intervertebral height, the limitation of vertebral activity, and the biomechanical changes of the lumbar spine, which in turn makes the lumbar anterior convex angle and sacral inclination angle smaller, and the pelvic inclination angle larger, affecting the stress distribution of the lumbar spine aggravating the intervertebral disc degeneration. If the spinal canal stenosis is not corrected for a long time, can cause the cauda equina nerve, nerve root compression, resulting in neurogenic intermittent claudication. If the spinal canal stenosis is not corrected for a long time, can cause the cauda equina nerve, nerve root compression, resulting in neurogenic intermittent claudication. Surgery can correct lumbar stenosis and reconstruct lumbar stability. But the traditional lumbar fusion trauma is huge, even can aggravate pain, spinal canal stenosis. Therefore, more and more patients are more inclined to MIS-TLIF treatment with less surgical trauma. For single-segment lumbar spinal stenosis, MIS-TLIF has the same effect as open surgery in restoring lumbar interbody height and improving lumbar-pelvis balance. Objective Discussion on the effect difference of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar spinal stenosis by Quadrant and MED methods. Methods A total of 96patients with lumbar spinal stenosis who were scheduled to undergo MIS-TLIF surgery in Our Hospital from January 2017 to October 2020 were selected and divided into group A and group B according to the surgical channel selection scheme, with 48 cases in each group. The patients in group A were treater with MED channel, and the patients in group B were treated with Quadrant channel. The degree of surgical trauma, VAS score before and postoperative, JOA score, lumbar-pelvic imaging parameters and surgical complications were compared between the two methods. Results The operation time of the A group was shorter than that of the group B(P < 0.05). The blood loss, exposure time under X line, drainage flow and down-ground time in A group were lower than those in B group, which had statistical significance (P<0.05) ; A and B groups of patients were compared, the difference was not statistically significant (P>0.05) ; Preoperative, Comparison of VAS scores between A and B groups, the difference was not statistically significant (P>0.05) . On the first day of postoperative, the VAS score of group A was lower than that of groupB, which had statistical significance (P < 0.05). Preoperative, Comparison of JOA scores between A and B groups, the difference was not statistically significant (P>0.05) ; Comparison of JOA scores between 1 month ,3 months and 6 months in Postoperative, the difference was not statistically significant (P>0.05). The JOA scores of the two groups at 1 month, 3 months and 6 months postoperative were significantly lower than those Preoperative (P < 0.05). Six months postoperative, the lumbar anterior convex angle, segmental anterior convex angle and intervertebral height of the two groups were significantly higher than those Preoperative (P<0.05), and the pelvic inclination angle of the two groups was lower than that Preoperative (P<0.05).Conclusion MIS-TLIF in the treatment of patients with lumbar spinal stenosis using MED channel or Quadrant channel operation has curative effect, and there is little difference in the recovery of lumbar-pelvis imaging parameters, but the former has the advantages of less surgical trauma and lower postoperative pain.

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Degrees of Canal Stenosis, Levels of Interleukin-6 (IL-6) And C-Reactive Protein (CRP) Preoperative as Predictors of the Output of Neurogenic Claudication Outcome Score (NCOS) 8 Weeks Post-Decompression-Stabilization-Fusion in Degenerative Lumbar Spinal Stenosis Patients

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20220120 ◽

2022 ◽

Vol 12 (1) ◽

pp. 137-146

Author(s):

Nyoman Gede Bimantara ◽

I Ketut Suyasa ◽

I Gede Eka Wiratnaya

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Neurogenic Claudication ◽

C Reactive Protein ◽

Degenerative Lumbar Spinal Stenosis ◽

Lumbar Canal Stenosis ◽

Reactive Protein ◽

Canal Stenosis ◽

Magnetic Resonance Imaging Mri ◽

Lumbar Spinal

Introduction: Lumbar Spinal Stenosis (LSS) or spinal stenosis is the most common spinal disease in elderly patients. LSS is also one of the leading causes of spinal surgery in the world. The problem that is often encountered is the limited predictor of outcomes that are considered affordable and accurate, so as to provide education to patients about possible output after the surgery process is carried out. Therefore, a predictor is needed that is considered accurate and affordable such as the degree of measurable canal stenosis of Magnetic resonance imaging (MRI), serum levels of C-Reactive Protein (CRP) and Interleukin-6 (IL-6) Method: This study used a prospective cohort design conducted to compare Neurogenic Claudication Outcome Score scores among people with degenerative lumbar canal stenosis whose post-decompression-stabilization-fusion had higher degrees of canal stenosis (measured through Schizas grading of Magnetic resonance Imaging/MRI) examinations), as well as high pre-operative CRP and IL-6 levels with those with normal CRP and IL-6 levels. From the population of lumbar spinal stenosis, the selection of samples was conducted consecutively sampling. After that, statistical tests in the form of descriptor tests, normality tests, risk factor assessments with 2x2 cross tabulation, and proportion comparison analysis using the Fisher Exact test. Result: Severe lumbar canal stenosis degrees resulted in worse NCOS 8 weeks postoperative than mild degrees of lumbar canal stenosis, with statistically significant differences (p=0.008; p < 0.05) and RR 6.4 (0.99-41.08). High CRP levels resulted in worse NCOS 8 weeks postoperative than mild lumbar degrees of canal stenosis, with statistically significantly differences (p=0.008; p < 0.05) and RR 6.4 (0.99-41.08). High pre-operative IL-6 levels resulted in worse NCOS 8 weeks postoperative than normal pre-operative IL-6 levels with statistically significantly differences (p=0.002; p < 0.05) and RR 8 (1.24-51.50). Conclusion: Degrees of preoperative (mild) canal stenosis, high pre-operative CRP levels, and high levels of pre-operative IL-6 were predictors for better 8-week NCOS scores in patients with post-decompression-stabilizing-fusion degenerative LSS disease. Key words: Degenerative lumbar spinal stenosis, IL-6, CRP, canal degree stenosis, NCOS.

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A retrospective comparison of laminectomy and unilateral fenestration with foraminotomy on outcome of patients with lumbar spinal stenosis

Romanian Neurosurgery ◽

10.1515/romneu-2016-0002 ◽

2016 ◽

Vol 30 (1) ◽

pp. 6-14

Author(s):

D. Adam ◽

Ioana Hornea ◽

Gina Burduşa ◽

D. Iftimie ◽

Cristiana Moisescu

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Surgical Techniques ◽

Functional Improvement ◽

Unilateral Approach ◽

Retrospective Comparison ◽

Group A ◽

Group B ◽

Two Parameters ◽

Lumbar Spinal

Abstract Background: Neural decompression for lumbar spinal stenosis (LSS) can be performed, besides conventional lumbar laminectomy, by many other surgical techniques. Objective: The goal of this study is to analyze the results of laminectomy versus unilateral fenestration and foraminotomy with bilateral neural decompression in LSS patients. Methods: A number of 58 patients with lumbar spinal stenosis were divided into two groups: group A (no.=22) consists of patients that underwent a laminectomy procedure and group B (no.=36) of cases where unilateral fenestration with foraminotomy was used. Outcome was assessed at 1, 6 and 12 months postoperatively. Two parameters were evaluated: level of pain with the VAS (Visual Analogue Scale) score and the ODI (Oswestry Disability Index) scale for functional improvement. Results: The level of pain was reduced in both patient groups. Cases in group A maintained higher levels of back pain in the first postoperative month versus group B. Improvement was faster for those operated by unilateral approach. At 6 months and 1 year follow-ups, VAS values were very similar. All patients presented functional recovery evaluated with the ODI scale, that showed continuous improvement at 6 months and 1 year. Conclusions: Bilateral decompression by unilateral approach is an efficient method that represents the first option of treatment for patients with lateral lumbar spinal stenosis with unilateral or predominantly unilateral symptoms. For patients with severe central stenosis, classic laminectomy remains the first surgical choice.

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Effectiveness of a Gelatin–Thrombin Matrix Sealant (Floseal®) for Reducing Blood Loss During Microendoscopic Decompression Surgery for Lumbar Spinal Canal Stenosis: A Retrospective Cohort Study

Global Spine Journal ◽

10.1177/21925682211008835 ◽

2021 ◽

pp. 219256822110088

Author(s):

Kazunori Nomura ◽

Munehito Yoshida ◽

Motohiro Okada ◽

Yosuke Nakamura ◽

Kenichi Yawatari ◽

...

Keyword(s):

Cohort Study ◽

Blood Loss ◽

Retrospective Cohort ◽

Spinal Canal Stenosis ◽

Lumbar Spinal Canal Stenosis ◽

Canal Stenosis ◽

Postoperative Drainage ◽

Group A ◽

Group B ◽

Lumbar Spinal

Study Design: Retrospective cohort study. Objectives: To investigate the effectiveness and safety of a gelatin–thrombin matrix sealant (GTMS) during microendoscopic laminectomy (MEL) for lumbar spinal canal stenosis (LSCS). Methods: This study included 158 LSCS cases on hemostasis-affecting medication who underwent MEL by a single surgeon between September 2016 and August 2020. Patients were divided into 2 groups depending on whether GTMS was used (37 cases, Group A) or not (121 cases, Group B). Perioperative data related to bleeding or postoperative spinal epidural hematoma (PSEH) was investigated. Clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score for low back pain. Results: The mean intraoperative blood loss per level was greater in Group A (26.0 ± 20.3 g) than in Group B (13.6 ± 9.0 g), whereas the postoperative drainage volume was smaller in Group A (79.1 ± 42.5 g) than in Group B (97.3 ± 55.6 g). No revision surgeries for PSEH were required in Group A, while 2 (1.7%) revisions were required in Group B ( P = .957). The median JOA score improved significantly from the preoperative period to 1-year postoperatively in both Group A and B (total score, 16.0-23.5 and 17.0-25.0 points, respectively). Conclusions: The use of GTMS during MEL for LSCS may be associated with a reduction in postoperative drainage volume. The revision rate for PSEH was not affected significantly by the use of GTMS. Clinical outcomes (represented by the JOA score) were significantly improved after the surgery, regardless of GTMS use during MEL.

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The Influence of Pain Sensitivity on the Symptom Severity in Patients with Lumbar Spinal Stenosis

January 2018 - Pain Physician ◽

10.36076/ppj.2013/16/135 ◽

2013 ◽

Vol 2;16 (2;3) ◽

pp. 135-144

Author(s):

Jin S. JYeom

Keyword(s):

Back Pain ◽

Spinal Stenosis ◽

Disc Degeneration ◽

Lumbar Spinal Stenosis ◽

Pain Sensitivity ◽

Leg Pain ◽

Canal Stenosis ◽

Sf 36 ◽

The Individual ◽

Lumbar Spinal

Background: The symptom severity of back pain/leg pain is not correlated with the severity of degenerative changes and canal stenosis in lumbar stenosis. Considering the individual pain sensitivity might play an important role in pain perception, this discordance between the radiologic findings and clinical symptoms in degenerative lumbar stenosis might originate from the individual difference of pain sensitivity for back pain and/or leg pain. Objective: To determine the relationship among the clinical symptoms, radiologic findings, and the individual pain sensitivity in the patients with degenerative lumbar spinal stenosis. Study Design: Retrospective analysis of prospectively collected data. Setting: A spine center in the department of orthopedic surgery. Methods: In 94 patients who had chronic back pain and/or leg pain caused by degenerative lumbar spinal stenosis, a medical history, a physical examination, and completion of a series of questionnaires, including pain sensitivity questionnaire (PSQ) [total PSQ and PSQ-minor], Oswestry Disability Index (ODI), Visual Analog Pain Scale (VAS) for back pain, and Short Form36 (SF-36) were recorded on the first visit. Radiologic analysis was performed using the MRI findings. The grading of canal stenosis was based on the method by Schizas, and the degree of disc degeneration was graded from T2-weighted images with the Pfirrmann classification. The correlations among variables were statistically analyzed. Results: Total PSQ and PSQ-minor were not dependent on the grade of canal stenosis after gender adjustment. VAS for leg pain and back pain was highly associated with the total PSQ and the PSQ-minor. Total PSQ and PSQ-minor were also significantly associated with ODI. Among SF36 scales, the PSQ minor had significant correlations with SF-36 such as bodily pain (BP), Roleemotional (RE), and Mental Component Summary (MCS) after control of confounding variables such as body mass index (BMI), age, and the grade of canal stenosis/disc degeneration. Total PSQ was significantly associated with the SF-36 RP, BP, and RE. Furthermore, after adjustment for gender and pain sensitivity, there was no significant association between the grade of canal stenosis and VAS for back pain/leg pain and ODI, and no correlation was found between the grade of disc degeneration and VAS for back pain/leg pain and ODI, either. Limitations: The multiple lesions of canal stenosis and/or disc degeneration and the grade of facet degeneration were not considered as a variable. Conclusion: The current study suggests that the pain sensitivity could be a determining factor for symptom severity in the degenerative spinal disease. Key words: Pain sensitivity, pain sensitivity questionnaire, lumbar spinal stenosis, visual analog pain scale, Oswestry disability index, Short Form-36

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Post-operative Morbidity and Mortality of Lumbar Spinal Stenosis at one Teaching Hospital in North-eastern Benin.

Iranian Journal of Neurosurgery ◽

10.32598/irjns.6.1.3 ◽

2020 ◽

Vol 6 (1) ◽

pp. 13-20

Author(s):

Holden Olatoundji Fatigba ◽

◽

Luphin Hode ◽

Kisito Quenum ◽

Thierry Alihonou ◽

...

Keyword(s):

Spinal Stenosis ◽

Surgical Management ◽

Lumbar Spinal Stenosis ◽

Teaching Hospital ◽

Cauda Equina ◽

Canal Stenosis ◽

Republic Of Benin ◽

The Republic ◽

Lumbar Spinal ◽

Selection Of

Background and Aim: Surgical management of Lumbar Spinal Stenosis (LSS) is a common practice. This study aimed to report the morbidities and mortalities observed during surgical treatment of LSS and the outcome of these patients after management over an 8-year study period. Methods and Materials/Patients: It was a retrospective, descriptive, and transversal study performed at the Departmental Teaching Hospital of Borgou in the Republic of Benin (West Africa) from January 2010 to December 2018. This study included the patients who underwent surgical management for LSS. Type of complication, its management, and the patient’s outcomes was registered. Results: During the study period and based on the selection criteria, 239 patients were selected. These patients were divided into 135 men (56.5%) and 104 women (43.5%). The mean age of the patients was 52.3±10.9 years. Laminectomy was performed on one, two, and three lumbar spinal segments in 17.6%, 55.6% and 26.8% of cases, respectively. Laminectomy was associated with discectomy in 6.3% of the cases. No arthrodesis with spinal fixation was performed. Ninety percent of patients had no post-operative complications. Functional post-operative results were considered excellent, good, acceptable and poor in 32.1%, 52.1%, 10.9% and 4.9% of cases, respectively. Five types of complications were observed in 22 patients (9.2%). A reoperation was performed in 1.6% of cases. These different complications included dural tear (4.6%), wound infection (3.3%), stroke (0.8%), cauda equina syndrome (0.4%) and pseudomeningocele (0.4%). The mortality rate was 0.8% (n=2). Conclusion: Lumbar canal stenosis surgery is not without complications. Careful selection of patients, consideration of risk factors, and selection of an appropriate surgical strategy can reduce or avoid these complications.

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Radiographic outcomes of endoscopic decompression for lumbar spinal stenosis

Neurosurgical FOCUS ◽

10.3171/2019.2.focus18617 ◽

2019 ◽

Vol 46 (5) ◽

pp. E10 ◽

Cited By ~ 1

Author(s):

Siri Sahib Khalsa ◽

Hyeun Sung Kim ◽

Ravindra Singh ◽

Osama Nezar Kashlan

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Facet Joint ◽

Volumetric Analysis ◽

Facet Joints ◽

Bone Removal ◽

Endoscopic Decompression ◽

Radiographic Outcomes ◽

Lateral Recess Stenosis ◽

Lumbar Spinal

OBJECTIVELumbar central stenosis can theoretically be decompressed with minimal bone removal via an endoscopic approach. Although multiple studies have demonstrated an adequate radiographic decompression, none has quantified the volume of bone removal after endoscopic decompression. The objective of this study was to quantify the 3D volume of bone removed from the lamina and facet joints during endoscopic decompression for lumbar central and lateral recess stenosis.METHODSThis retrospective study included adults with lumbar spinal stenosis who underwent endoscopic decompression of a single level or 2 noncontiguous lumbar levels. Central stenosis on MRI was graded preoperatively and postoperatively using the Schizas scale. A computer program was developed in MATLAB to semiautomatically perform a 3D volumetric analysis of preoperative and postoperative lumbar CT scans. The volumetric percentage of bone removed from the lamina and facet joints ipsilateral and contralateral to the side of approach was quantified.RESULTSNineteen patients with 21 treated lumbar levels were included in the study. Preoperatively, the number of levels with Schizas stenosis grades B, C, and D were 5, 12, and 4, respectively. Stenosis grades improved postoperatively to grades A, B, C, and D for 17, 3, 1, and 0 levels, respectively. All levels improved by at least 1 stenosis grade. The volumetric percentage of laminar bone removed was 15.5% (95% CI 11.2%–19.8%, p < 0.001) from the ipsilateral lamina and 8.8% (95% CI 5.7%–11.8%, p < 0.001) from the contralateral lamina. The percentage of facet joint resection was 5.3% (95% CI 4.2%–6.4%, p < 0.001) and 4.3% (95% CI 2.2%–6.4%, p < 0.001) for the ipsilateral and contralateral facet joints, respectively. Average pain scores, as measured by the visual analog scale, improved from 7.9 preoperatively to 2.2 by 3–10 months postoperatively (p < 0.001).CONCLUSIONSEndoscopic lumbar decompression achieves improvement in the radiographic grade of lumbar central stenosis with minimal bone removal from the lamina and facet joints. Future prospective studies are needed to validate the findings of this study with more comprehensive clinical outcomes.

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Outcomes of Revision Surgery Following Instrumented Posterolateral Fusion in Degenerative Lumbar Spinal Stenosis: A Comparative Analysis between Pseudarthrosis and Adjacent Segment Disease

Asian Spine Journal ◽

10.4184/asj.2017.11.3.463 ◽

2017 ◽

Vol 11 (3) ◽

pp. 463-471 ◽

Cited By ~ 4

Author(s):

Seung-Pyo Suh ◽

Young-Hoon Jo ◽

Hae Won Jeong ◽

Won Rak Choi ◽

Chang-Nam Kang

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Revision Surgery ◽

Adjacent Segment Disease ◽

Posterolateral Fusion ◽

Adjacent Segment ◽

Degenerative Lumbar Spinal Stenosis ◽

Group A ◽

Lumbar Spinal

<sec><title>Study Design</title>Retrospective study.</sec><sec><title>Purpose</title>We examined the clinical and radiological outcomes of patients who received revision surgery for pseudarthrosis or adjacent segment disease (ASD) following decompression and instrumented posterolateral fusion (PLF).</sec><sec><title>Overview of Literature</title>At present, information regarding the outcomes of revision surgery for complications such as pseudarthrosis and ASD following instrumented PLF is limited.</sec><sec><title>Methods</title>This study examined 60 patients who received PLF for degenerative lumbar spinal stenosis and subsequently developed pseudarthrosis or ASD leading to revision surgery. Subjects were divided into a group of 21 patients who received revision surgery for pseudarthrosis (Group P) and a group of 39 patients who received revision surgery for ASD (Group A). Clinical outcomes were evaluated using the visual analogue scales for back pain (VAS-BP) and leg pain (VAS-LP), the Korean Oswestry disability index (K-ODI), and each patient's subjective satisfaction. Radiological outcomes were evaluated from the extent of bone union, and complications in the two groups were compared.</sec><sec><title>Results</title>VAS-LP at final follow-up was not statistically different between the two groups (<italic>p</italic> =0.353), although VAS-BP and K-ODI at final follow-up were significantly worse in Group P than in Group A (all <italic>p</italic> <0.05), and only 52% of the patients in Group P felt that their overall well-being had improved following revision surgery. Fusion rates after the first revision surgery were 71% (15/21) in Group P and 95% (37/39) in Group A (<italic>p</italic> =0.018). The rate of reoperation was significantly higher in Group P (29%) than in Group A (5%) (<italic>p</italic> =0.021) due to complications.</sec><sec><title>Conclusions</title>Clinical and radiological outcomes were worse in patients who had received revision surgery for pseudarthrosis than in those who had revision surgery for ASD. Elderly patients should be carefully advised of the risks and benefits before planning revision surgery for pseudarthrosis.</sec>

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X-RAY AND MAGNETIC RESONANCE IMAGING FEATURES IN PATIENTS WITH ACQUIRED LUMBAR SPINAL STENOSIS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.6.20 ◽

2018 ◽

Vol 8 (6) ◽

pp. 151-156

Author(s):

Trung Hoang Van ◽

Cuong Le Van Ngoc

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Spinal Canal ◽

Resonance Imaging ◽

X Ray ◽

Canal Stenosis ◽

Lumbar Spinal Canal ◽

Lumbar Spinal

Background: Lumbar spinal stenosis often associates with chronic pain described the abnormal narrowing of the lumbar spinal canal, resulting in compression of neural elements within the central spinal canal or the lateral recesses or the root canals or coordinate with each other. The purpose of this study was to describe and compare the plain X-ray and magnetic resonance imaging features of lumbar canal stenosis. Materials and methods: This was a cross-sectional study of 78 patients with an acquired lumbar spinal canal between October 2017 and May 2018. Results: The X-rays confirmed osteophytes in 92.3%, endplate sclerosis in 88.5% and disc space narrowing 62.8%. On MRI, 213 lumbar levels were lumbar spinal canal stenosis, 181 lumbar levels were evaluated for the grade of central spinal canal stenosis. Conclusions: X-ray examination has limitations in a diagnosis of lumbar spinal stenosis but also serves as a diagnostic aid. MRI is well diagnosed as spinal pathology as well as lumbar spinal stenosis. Key words: Lumbar spinal, Lumbar spinal stenosis, Magnetic resonance imaging (MRI), X-ray, Grading

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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

Tobacco Regulatory Science ◽

10.18001/trs.7.6.129 ◽

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.

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