Endoscope-assisted spinal decompression surgery for lumbar spinal stenosis

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• Lumbar spinal stenosis (LSS) significantly impacts patient quality of life, often necessitating surgical intervention.
• Conservative treatments for LSS may fail, leading to persistent neurological symptoms and pain.

Purpose of the Study:

• To evaluate the clinical outcomes of microendoscopic laminotomy for lumbar decompression in patients with LSS.
• To assess the safety and efficacy of this minimally invasive surgical technique.

Main Methods:

• A cohort of 366 patients with LSS underwent microendoscopic laminotomy between 2007 and 2010.
• Surgical outcomes were assessed using the Japanese Orthopaedic Association (JOA) score, Roland-Morris Disability Questionnaire (RMDQ), JOABPEQ, and SF-36, evaluated preoperatively and at 2-year follow-up.
• Microendoscopy allowed for wide visualization and bilateral decompression through a unilateral approach, preserving spinal ligaments and musculature.

Main Results:

• Effective decompression was achieved in all patients, with a 2-year follow-up for 310 patients.
• The average JOA recovery rate was 61.3%, with 69.8% of patients achieving excellent or good outcomes.
• Significant improvements were observed in RMDQ, JOABPEQ, and SF-36 scores (p < 0.001), indicating enhanced function and reduced pain.
• Minor complications included dural tear (1.9%), wrong-level operation (0.3%), transient neuralgia (1.3%), and infection (0.3%), with no serious adverse events.

Conclusions:

• Microendoscopic laminotomy is a safe and highly effective minimally invasive surgical procedure for treating degenerative lumbar spinal stenosis.
• The technique provides significant clinical benefits, improving patient function and pain levels with a low complication rate.