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World Neurosurg. 2017 Jul;103:201-209. doi: 10.1016/j.wneu.2017.03.130. Epub 2017 Apr 5.

Percutaneous Full Endoscopic Bilateral Lumbar Decompression of Spinal Stenosis Through Uniportal-Contralateral Approach: Techniques and Preliminary Results.

Author information

1
Department of Neurosurgery, Nanoori Suwon Hospital, Suwon-si, Gyeonggi-do, Republic of Korea.
2
Department of Neurosurgery, Nanoori Suwon Hospital, Suwon-si, Gyeonggi-do, Republic of Korea. Electronic address: drbyapak@gmail.com.
3
Department of Neurosurgery, Nanoori Incheon Hospital, Bupyeong-gu, Incheon, Republic of Korea.
4
Department of Neurosurgery, Nanoori Seoul Hospital, Gangnam-gu, Seoul, Republic of Korea.

Abstract

BACKGROUND:

When considering various risk factors such as age, comorbidities, and complications related to the surgical procedure itself, open surgery in degenerative spinal stenosis is likely to cause more complications. Here, we report the surgical procedure and preliminary clinical results of percutaneous endoscopic stenosis lumbar decompression (PESLD) technique using a uniportal-contralateral approach for bilateral decompression of degenerative spinal stenosis.

MATERIALS AND METHODS:

Electronic medical records of 48 consecutive patients who were treated between January 2016 and August 2016 were reviewed retrospectively. All patient received PESLD through the uniportal-contralateral approach. We analyzed the outcomes using the visual analogue scale, Macnab criteria, Oswestry Disability Index, and complication rate.

RESULTS:

There were 48 cases (15 men, 33 women). Mean age of patients was 62.44 ± 8.68 years. Mean symptom duration was 20.13 ± 16.87 months. Neurogenic intermittent claudication was 550 m on average. Follow-up period was 7.75 ± 2.28 months (range, 5-13 months). Visual analogue scale and Oswestry Disability Index decreased significantly (P < 0.001) and decreased by 1.073 and 5.795 odds ratio, respectively, in contralateral foraminotomy cases. Macnab outcome grade was good to excellent in 96% of patients. Dural tear occurred in 3 cases (6.25%), and 2 cases (4.17%) required transforaminal lumbar interbody fusion operation after this procedure.

CONCLUSIONS:

The preliminary result of this uniportal-contralateral PESLD technique is encouraging (96% demonstrated a good-to-excellent outcome), and the procedure is safe. However, we need long-term follow-up and a more detailed study for more accurate results of this technique.

KEYWORDS:

Bilateral decompression; Degenerative spinal stenosis; Endoscopic decompression; Percutaneous endoscopic stenosis lumbar decompression (PESLD); Uniportal–contralateral approach

PMID:
28389410
DOI:
10.1016/j.wneu.2017.03.130
[Indexed for MEDLINE]
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