Unilateral Laminectomy by Endoscopy in Central Lumbar Canal Spinal Stenosis: Technical Note and Early Outcomes.

STUDY

DESIGN

Retrospective study.

OBJECTIVE

To evaluate the outcomes and safety of endoscopic laminectomy for central lumbar canal spinal stenosis.

SUMMARY OF BACKGROUND DATA: .: Spinal endoscopy is mostly used in the treatment of lumbar disc herniation, while endoscopic laminectomy for lumbar spinal stenosis is rarely reported.

METHODS

From January 2016 to June 2017, 38 patients with central lumbar canal spinal stenosis were treated with endoscopic laminectomy. Clinical symptoms were evaluated at 1, 3, 6, and 12 months and the last follow-up after surgery. Functional outcomes were assessed by using the Japanese Orthopedic Association Scores (JOA) and Oswestry Disability Index (ODI). The decompression effect was assessed by using the dural sac cross-sectional area (DSCA). Lumbar stability was evaluated using lumbar range of motion (ROM), ventral intervertebral space height (VH), and dorsal intervertebral space height (DH).

RESULTS

The mean age of the cases was 60.8 years, the mean operation time was 66.3 minutes, the blood loss was 38.8 mL, and the length of incision was 19.6 mm. The mean time in bed was 22.3 hours, and the mean hospital stay was 8.8 days. JOA scores were improved from 10.9 to 24.1 (P < 0.05), ODI scores were improved from 79.0 to 27.9 (P < 0.05), DSCA was improved from 55.7 to 109.5 mm (P < 0.05), ROM scores were improved from 5.6° to 5.7° (P < 0.05), and DH scores were reduced from 6.6 to 6.5 mm (P < 0.05). There was no significant difference in VH before and after operation (P > 0.05). There were no serious complications during the follow-ups.

CONCLUSION

Endoscopic laminectomy had the advantage of a wider view, which was effective, safe, and less invasive for lumbar spinal stenosis.

LEVEL OF EVIDENCE: 5.