Treatment of lumbar spinal stenosis by using percutaneous coaxial endoscopic combined transforaminal and interlaminar approaches: a primary report

English Keywords:Minimally invasive  Endoscopy  Lumbar spinal stenosis  Transforaminal approach  Interlaminar approach

English Abstract:

  【Abstract】 Objectives: To retrospectively investigate the clinic outcome of the percutaneous coaxial endoscopic combined transforaminal and interlaminar approaches for mixed lumbar spine canal stenosis. Methods: Thirteen cases with mixed lumbar spinal stenosis underwent percutaneous endoscopic decompression by combined transforaminal and interlaminar approaches from June 2012 to January 2015. The neurogenic intermittent claudication was presented in all patients. The visual analogue scale(VAS) scores and Oswestry disability index(ODI) scores were recorded preoperatively and at final follow-up to evaluate the back and sciatica pain and the function of lumbar. The Nakai criteria were involved to assess the recovery rate. Results: All procedures were performed in local anesthesia successfully. There were two complications noted, one sheath of nerve root tear and one bleeding intraoperatively. Fortunately, no severe consequence was noted after the procedure. The mean duration of hospital stay was 4.7±1.2 days and the average follow-up time was 19.6±9.0 months. The VAS scores of back pain and the sciatica decreased from 4.6±0.8 and 4.7±0.9 preoperatively to 1.8±0.9 and 1.0±0.7 at final follow-up. The ODI score decreased from (32.7±6.9)% preoperatively to (10.5±3.0)% at final follow-up. All data mentioned above showed significant differences between pre- and postoperation(P<0.01). The excellent and good rate was 76.9% according to Nakai criteria(excllent: 6; good: 4, fair: 2; bad: 1). Conclusions: It is effective and safe for mixed lumbar stenosis by using percutaneous endoscopic combined transforaminal and interlaminar approaches, which have the advantages of less invasive, rapid recovery and short duration of hospital stay. This technique can be used as an alternative for the mixed lumbar stenosis, especially for the elderly patient with high risk for general anesthesia.