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Published on: November 17, 2023
Assisted full-endoscopic spine surgery for lumbar spinal stenosis: Technical note and learning curve
Koichiro Ono1, Daisuke Fukuhara1,2, Yuka Yamami1
1Department of Orthopedic Surgery, Nippon Medical School, Tokyo, Japan.
Assisted full-endoscopic spine surgery (AFESS) effectively treats lumbar spinal stenosis (LSS), offering significant pain relief and high facet joint preservation. This minimally invasive technique demonstrates a clear learning curve, indicating safe and efficient clinical integration.
Area of Science:
- Minimally Invasive Spine Surgery
- Spinal Decompression Techniques
- Orthopedic Surgery
Background:
- Lumbar spinal stenosis (LSS) causes debilitating back and leg pain.
- Conventional full-endoscopic spine surgery has limitations.
- Assisted full-endoscopic spine surgery (AFESS) aims to combine advantages of uniportal and biportal approaches.
Purpose of the Study:
- To evaluate the efficacy of AFESS for LSS decompression.
- To assess the degree of facet joint preservation with AFESS.
- To determine the learning curve associated with the AFESS technique.
Main Methods:
- Retrospective review of 33 LSS patients treated with AFESS.
- Patients divided into initial (20) and advanced (13) phases.
- Outcomes: operative time, facet joint preservation, complications, VAS pain scores (6-month follow-up).
Main Results:
- Operative time significantly decreased (99 to 72 min) from initial to advanced phases.
- Facet joint preservation improved in the advanced phase (76.2% vs 68.9%).
- Significant VAS pain reduction for both lumbar and radicular pain in both phases (p < 0.01).
Conclusions:
- AFESS is a safe and effective treatment for LSS.
- Achieves adequate decompression with substantial facet preservation and pain relief.
- Demonstrates a manageable learning curve for clinical adoption.
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