INNOVATIVE FULL-ENDOSCOPIC DECOMPRESSION TECHNIQUE FOR LUMBAR SPINAL STENOSIS: PROMISING EARLY RESULTS FROM VIETNAM

This study aimed to evaluate the early outcomes of full-endoscopic decompression using the outside-in technique via the interlaminar approach for treating lumbar spinal stenosis in Vietnamese patients.

A retrospective review was conducted on 25 consecutive patients with lumbar spinal stenosis (16 men and 9 women; mean age ± SD: 65.80 ± 8.41 years) who underwent full-endoscopic decompression. Clinical outcomes were analyzed using the Visual Analog Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI) preoperatively, immediately postoperatively, and at a three-month follow-up. The final outcome was evaluated using the MacNab criteria.

Among the 25 patients, the L4-L5 level was the most common site of stenosis (17 patients, 68%), with central canal stenosis observed in 10 patients (40%). The primary causes of stenosis were hypertrophy of the facet joints combined with ligamentum flavum thickening (9 patients, 36%) and disc herniation (11 patients, 44%). Unilateral decompression was performed in 20 patients (80%), while bilateral decompression was required in 5 patients (20%). The mean operative time was 50.96 ± 16.20 minutes, and the average hospital stay was 2.13 ± 0.52 days, with no reported complications. VAS scores for back pain decreased from 7.60 preoperatively to 1.80 at 6 months, and leg pain scores from 7.20 to 1.76. The ODI improved from 76.35 preoperatively to 10.34 at 6 months. MRI results showed a significant increase in the canal cross-sectional area, from 75.78 mm² to 155.2 mm². Based on Mac-Nab criteria, 80% of patients achieved excellent results, 16% good, and 4% fair at 6 months.

Full-endoscopic decompression of lumbar canal stenosis demonstrates promising early outcomes. Advances in endoscopic surgical instruments facilitate decompression procedures that can be performed as effectively, if not more so, than traditional open decompression surgery.