Journal of orthopaedics · 2018
Unilateral biportal endoscopic decompression by 30° endoscopy in lumbar spinal stenosis: Technical note and preliminary report.
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Kim Ju-Eun, Choi Dae-Jung
Аннотация
BACKGROUND CONTEXT: Open laminectomy has been regarded as the standard surgical method up to date in degenerative spinal stenosis or herniation of intervertebral disc. The conventional method may lead to instability and provoke chronic lower back pain by scarifying facet joint, posterior ligamentous complex as well as paraspinal muscle. For this reason, the new technique using an endoscope, which could protect soft tissue and facet joint, recently got spotlight.
PURPOSE: The aim of this study is to introduce a new spinal surgical technique using a 30-degreed endoscopy through bi- or tri- portals and to report the preliminary result of this technique.
STUDY DESIGN: retrospective study.
METHODS: One hundred five patients who were suffering from neurologic symptoms by degenerative lumbar spine disease were included even after preoperative conservative treatment. Two or three portals were used for each level. One portal was used for viewing, the others, for working of a certain instrument. Unilateral laminotomy was followed by bilateral decompression under 30° endoscopy. Clinical outcomes were analyzed in view of modified-Macnab criteria, Oswestry Disability Index (ODI), Visual analog scale (VAS), and postoperative complications were analyzed.
RESULTS: The ODI improved from 67.4 ± 11.5 preoperatively to 22.9 ± 12.4 postoperatively. VAS for leg decreased from 7.7 ± 1.5 to 2.4 ± 1.3 at final follow up. Eighty-eight percent of the patients were improved over a level of good based on the Macnab criteria. There were not infection case.
CONCLUSIONS: The 30-degreed endoscopy had the advantages of obtaining a wider view. Full endoscopic decompression using 30-degreed endoscopy allowed satisfactory result clinically and reduction of surgical infection. It could be alternative method of microscopic laminectomy.
PURPOSE: The aim of this study is to introduce a new spinal surgical technique using a 30-degreed endoscopy through bi- or tri- portals and to report the preliminary result of this technique.
STUDY DESIGN: retrospective study.
METHODS: One hundred five patients who were suffering from neurologic symptoms by degenerative lumbar spine disease were included even after preoperative conservative treatment. Two or three portals were used for each level. One portal was used for viewing, the others, for working of a certain instrument. Unilateral laminotomy was followed by bilateral decompression under 30° endoscopy. Clinical outcomes were analyzed in view of modified-Macnab criteria, Oswestry Disability Index (ODI), Visual analog scale (VAS), and postoperative complications were analyzed.
RESULTS: The ODI improved from 67.4 ± 11.5 preoperatively to 22.9 ± 12.4 postoperatively. VAS for leg decreased from 7.7 ± 1.5 to 2.4 ± 1.3 at final follow up. Eighty-eight percent of the patients were improved over a level of good based on the Macnab criteria. There were not infection case.
CONCLUSIONS: The 30-degreed endoscopy had the advantages of obtaining a wider view. Full endoscopic decompression using 30-degreed endoscopy allowed satisfactory result clinically and reduction of surgical infection. It could be alternative method of microscopic laminectomy.