A Comparative Study of Clinical Outcomes in Full-Endoscopic Interlaminar Discectomy for Patients With Congenital and Non-Congenital Lumbar Spinal Canal Stenosis: A Midterm Results.

STUDY

DESIGN

A comparative study.

BACKGROUND

Congenital lumbar spinal canal stenosis (CLSS) is characterized by maldevelopment of the dorsal spinal elements, which results in a constricted spinal canal. Endoscopic discectomy procedures in patients with CLSS present more significant challenges in achieving sufficient decompression than those in patients with noncongenital spinal stenosis. To our knowledge, no studies disaggregate the outcomes of endoscopic discectomy between CLSS and non-CLSS patients.

OBJECTIVE

To compare the clinical outcomes of full endoscopic interlaminar discectomy (FEID) in patients diagnosed with congenital lumbar spinal canal stenosis (CLSS) against those with non-congenital lumbar spinal canal stenosis (non-CLSS).

METHODS

Between 2016 and 2020, patients who underwent full-endoscopic discectomy at our institution were enrolled in this study. Inclusion criteria included individuals under 50 years of age, presenting symptoms of lumbar disc herniation with a positive straight leg raise test, failed conservative treatment, and no prior lumbar spine surgeries. Outcomes measured included operative times, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), and modified Macnab criteria at 1 day, 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and 2 years postoperatively.

RESULTS

Fifty-six patients participated in the study, with 22 in the CLSS group and 34 in the non-CLSS group. Visual Analog Scale (VAS) scores for back and leg pain, along with the Oswestry Disability Index (ODI) scores, were measured at various time points postoperatively. No significant differences were found between the groups (p > 0.05). According to the modified Macnab criteria, 100% of the CLSS group reported good to excellent results, compared to 91% of the non-CLSS group (p = 0.6690). Both groups showed improvements in VAS and ODI scores at immediate, short-term, and long-term follow-ups (p < 0.05). Mean operative times were 53.09 min for CLSS and 43.26 min for non-CLSS, with a p-value of 0.053.

CONCLUSIONS

Endoscopic discectomy has demonstrated an enhancement in clinical outcomes for patients with lumbar disc herniation when comparing preoperative and postoperative results in both CLSS and non-CLSS groups. No significant differences in clinical outcomes were observed between the CLSS and non-CLSS groups.