Comparative Analysis between Three Different Lumbar Decompression Techniques (Microscopic, Tubular, and Endoscopic) in Lumbar Canal and Lateral Recess Stenosis: Preliminary Report

Purpose. The purpose of our study is to compare the results of spinal decompression using the full-endoscopic interlaminar technique, tubular retractor, and a conventional microsurgical laminotomy technique and evaluate the advantages and clinical feasibility of minimally invasive spinal (MIS) lumba...

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Published in:BioMed research international 2019-01, Vol.2019 (2019), p.1-11
Main Authors: Lee, Chul-Woo, Ha, Sang-Soo, Yoon, Kang-Jun
Format: Article
Language:English
Subjects:
Aged
Back pain
Back surgery
Backache
Comparative analysis
Complications
Decompression
Endoscopy
Feasibility studies
Humans
Intervertebral discs
Laminectomy
Microsurgery
Middle Aged
Muscles
Neurosurgery
Neurosurgical Procedures
Pain
Patients
Retrospective Studies
Spinal Stenosis - diagnostic imaging
Spinal Stenosis - physiopathology
Spinal Stenosis - surgery
Statistical analysis
Stenosis
Surgeons
Surgery
Trauma
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Ha, Sang-Soo
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description Purpose. The purpose of our study is to compare the results of spinal decompression using the full-endoscopic interlaminar technique, tubular retractor, and a conventional microsurgical laminotomy technique and evaluate the advantages and clinical feasibility of minimally invasive spinal (MIS) lumbar decompression technique in the lumbar canal and lateral recess stenosis. Methods. The authors retrospectively reviewed clinical and radiological data from 270 patients who received microsurgical (group E: 72 patients), tubular (group T: 34 patients), or full-endoscopic decompression surgery (group E: 164 patients) for their lumbar canal and lateral recess stenosis from June 2016 to August 2017. Clinical (VAS, ODI, and Mcnab criteria), radiologic (spinal canal diameter, segmental dynamic angle, and disc height), and surgical outcome parameters (CPK level, Operative time, blood loss, and hospital stay) were evaluated pre- and postoperatively and compared among the three groups by means of statistical analysis. Failed cases and complications were reviewed in all groups. Results. The mean follow-up period was 6.38 months. The Overall clinical success rate was 89.4%. All groups showed favorable clinical outcome. The clinical and radiologic results were similar in all groups. Regarding surgical outcome, group E showed longer operation time than group M and T (group E: 84.17 minutes/level, group M: 52.22 minutes/level, and group T: 66.12 minutes/level) (p
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The purpose of our study is to compare the results of spinal decompression using the full-endoscopic interlaminar technique, tubular retractor, and a conventional microsurgical laminotomy technique and evaluate the advantages and clinical feasibility of minimally invasive spinal (MIS) lumbar decompression technique in the lumbar canal and lateral recess stenosis. Methods. The authors retrospectively reviewed clinical and radiological data from 270 patients who received microsurgical (group E: 72 patients), tubular (group T: 34 patients), or full-endoscopic decompression surgery (group E: 164 patients) for their lumbar canal and lateral recess stenosis from June 2016 to August 2017. Clinical (VAS, ODI, and Mcnab criteria), radiologic (spinal canal diameter, segmental dynamic angle, and disc height), and surgical outcome parameters (CPK level, Operative time, blood loss, and hospital stay) were evaluated pre- and postoperatively and compared among the three groups by means of statistical analysis. Failed cases and complications were reviewed in all groups. Results. The mean follow-up period was 6.38 months. The Overall clinical success rate was 89.4%. All groups showed favorable clinical outcome. The clinical and radiologic results were similar in all groups. Regarding surgical outcome, group E showed longer operation time than group M and T (group E: 84.17 minutes/level, group M: 52.22 minutes/level, and group T: 66.12 minutes/level) (p&lt;0.05). However, groups E and T showed minimal surgical invasiveness compared with group M. Groups E and T showed less immediate postoperative back pain (VAS) (group E: 3.13, group M: 4.28, group T: 3.54) (p&lt;0.05), less increase of serum CPK enzyme (group E: 66.38 IU/L, group M: 120 IU/L, and group T: 137.5 IU/L) (p&lt;0.05), and shorter hospital stay (group E: 2.12 days, group M: 4.85 days, and group T: 2.83 days) (p&lt;0.05). The rates of complications and revisions were not significantly different among the three groups. Conclusions. MIS decompression technique is clinically feasible and safe to treat the lumbar canal and lateral recess stenosis, and it has many surgical advantages such as less muscle trauma, minimal postoperative back pain, and fast recovery of the patient compared to traditional open microscopic technique.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2019/6078469</identifier><identifier>PMID: 31019969</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Aged ; Back pain ; Back surgery ; Backache ; Comparative analysis ; Complications ; Decompression ; Endoscopy ; Feasibility studies ; Humans ; Intervertebral discs ; Laminectomy ; Microsurgery ; Middle Aged ; Muscles ; Neurosurgery ; Neurosurgical Procedures ; Pain ; Patients ; Retrospective Studies ; Spinal Stenosis - diagnostic imaging ; Spinal Stenosis - physiopathology ; Spinal Stenosis - surgery ; Statistical analysis ; Stenosis ; Surgeons ; Surgery ; Trauma</subject><ispartof>BioMed research international, 2019-01, Vol.2019 (2019), p.1-11</ispartof><rights>Copyright © 2019 Chul-Woo Lee et al.</rights><rights>COPYRIGHT 2019 John Wiley &amp; Sons, Inc.</rights><rights>Copyright © 2019 Chul-Woo Lee et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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The purpose of our study is to compare the results of spinal decompression using the full-endoscopic interlaminar technique, tubular retractor, and a conventional microsurgical laminotomy technique and evaluate the advantages and clinical feasibility of minimally invasive spinal (MIS) lumbar decompression technique in the lumbar canal and lateral recess stenosis. Methods. The authors retrospectively reviewed clinical and radiological data from 270 patients who received microsurgical (group E: 72 patients), tubular (group T: 34 patients), or full-endoscopic decompression surgery (group E: 164 patients) for their lumbar canal and lateral recess stenosis from June 2016 to August 2017. Clinical (VAS, ODI, and Mcnab criteria), radiologic (spinal canal diameter, segmental dynamic angle, and disc height), and surgical outcome parameters (CPK level, Operative time, blood loss, and hospital stay) were evaluated pre- and postoperatively and compared among the three groups by means of statistical analysis. Failed cases and complications were reviewed in all groups. Results. The mean follow-up period was 6.38 months. The Overall clinical success rate was 89.4%. All groups showed favorable clinical outcome. The clinical and radiologic results were similar in all groups. Regarding surgical outcome, group E showed longer operation time than group M and T (group E: 84.17 minutes/level, group M: 52.22 minutes/level, and group T: 66.12 minutes/level) (p&lt;0.05). However, groups E and T showed minimal surgical invasiveness compared with group M. Groups E and T showed less immediate postoperative back pain (VAS) (group E: 3.13, group M: 4.28, group T: 3.54) (p&lt;0.05), less increase of serum CPK enzyme (group E: 66.38 IU/L, group M: 120 IU/L, and group T: 137.5 IU/L) (p&lt;0.05), and shorter hospital stay (group E: 2.12 days, group M: 4.85 days, and group T: 2.83 days) (p&lt;0.05). The rates of complications and revisions were not significantly different among the three groups. Conclusions. MIS decompression technique is clinically feasible and safe to treat the lumbar canal and lateral recess stenosis, and it has many surgical advantages such as less muscle trauma, minimal postoperative back pain, and fast recovery of the patient compared to traditional open microscopic technique.</description><subject>Aged</subject><subject>Back pain</subject><subject>Back surgery</subject><subject>Backache</subject><subject>Comparative analysis</subject><subject>Complications</subject><subject>Decompression</subject><subject>Endoscopy</subject><subject>Feasibility studies</subject><subject>Humans</subject><subject>Intervertebral discs</subject><subject>Laminectomy</subject><subject>Microsurgery</subject><subject>Middle Aged</subject><subject>Muscles</subject><subject>Neurosurgery</subject><subject>Neurosurgical Procedures</subject><subject>Pain</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Spinal Stenosis - diagnostic imaging</subject><subject>Spinal Stenosis - physiopathology</subject><subject>Spinal Stenosis - surgery</subject><subject>Statistical analysis</subject><subject>Stenosis</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Trauma</subject><issn>2314-6133</issn><issn>2314-6141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNqNkk1v1DAQhiMEolXpjTOyxKWIXWrHjmP3gLTalg9pEQiWs-U4k66rxA520qq_q3-wDrvdAid88UjvM--Mx5NlLwl-R0hRnOaYyFOOS8G4fJId5pSwOSeMPN3HlB5kxzFe4XQE4Vjy59kBJSlPcnmY3S191-ugB3sNaOF0exttRBUMNwAOrTcBAJ3bpoEAbkCrsat0QOdgUlaAGK1PEJiNs79GiOjkizXBR-N7a2ZoPVZjq8MMaVejC1fvhDfIugenpU4lf-srPUBI8XcwyRf9GMD51MoZ-hagtZ11OtwmsfdheJE9a3Qb4Xh3H2U_P1ysl5_mq68fPy8Xq7lhUg7zWlJeCZk3AgMlDQNeiJKxwhhWUkxLqZkQsqw4FLwmFGhRS6gqI4iguZaSHmXvt779WHVQmzSB1KHqg-1SM8prq_5WnN2oS3-tOCuIyItkcLIzCH6az6A6Gw20rXbgx6jynBSYcM5ZQl__g175MaThTBRmBc25II_UpW5BWdf4VNdMpmrBiczT_-LJa7alpr-IAZp9ywSraW3UtDZqtzYJf_XnM_fww5Ik4O0W2FhX6xv7n3aQGGj0I03yNBhG7wF3iNUU</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Lee, Chul-Woo</creator><creator>Ha, Sang-Soo</creator><creator>Yoon, Kang-Jun</creator><general>Hindawi Publishing Corporation</general><general>Hindawi</general><general>John Wiley &amp; 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The purpose of our study is to compare the results of spinal decompression using the full-endoscopic interlaminar technique, tubular retractor, and a conventional microsurgical laminotomy technique and evaluate the advantages and clinical feasibility of minimally invasive spinal (MIS) lumbar decompression technique in the lumbar canal and lateral recess stenosis. Methods. The authors retrospectively reviewed clinical and radiological data from 270 patients who received microsurgical (group E: 72 patients), tubular (group T: 34 patients), or full-endoscopic decompression surgery (group E: 164 patients) for their lumbar canal and lateral recess stenosis from June 2016 to August 2017. Clinical (VAS, ODI, and Mcnab criteria), radiologic (spinal canal diameter, segmental dynamic angle, and disc height), and surgical outcome parameters (CPK level, Operative time, blood loss, and hospital stay) were evaluated pre- and postoperatively and compared among the three groups by means of statistical analysis. Failed cases and complications were reviewed in all groups. Results. The mean follow-up period was 6.38 months. The Overall clinical success rate was 89.4%. All groups showed favorable clinical outcome. The clinical and radiologic results were similar in all groups. Regarding surgical outcome, group E showed longer operation time than group M and T (group E: 84.17 minutes/level, group M: 52.22 minutes/level, and group T: 66.12 minutes/level) (p&lt;0.05). However, groups E and T showed minimal surgical invasiveness compared with group M. Groups E and T showed less immediate postoperative back pain (VAS) (group E: 3.13, group M: 4.28, group T: 3.54) (p&lt;0.05), less increase of serum CPK enzyme (group E: 66.38 IU/L, group M: 120 IU/L, and group T: 137.5 IU/L) (p&lt;0.05), and shorter hospital stay (group E: 2.12 days, group M: 4.85 days, and group T: 2.83 days) (p&lt;0.05). The rates of complications and revisions were not significantly different among the three groups. Conclusions. MIS decompression technique is clinically feasible and safe to treat the lumbar canal and lateral recess stenosis, and it has many surgical advantages such as less muscle trauma, minimal postoperative back pain, and fast recovery of the patient compared to traditional open microscopic technique.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>31019969</pmid><doi>10.1155/2019/6078469</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6562-977X</orcidid><oa>free_for_read</oa></addata></record>
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subjects Aged
Back pain
Back surgery
Backache
Comparative analysis
Complications
Decompression
Endoscopy
Feasibility studies
Humans
Intervertebral discs
Laminectomy
Microsurgery
Middle Aged
Muscles
Neurosurgery
Neurosurgical Procedures
Pain
Patients
Retrospective Studies
Spinal Stenosis - diagnostic imaging
Spinal Stenosis - physiopathology
Spinal Stenosis - surgery
Statistical analysis
Stenosis
Surgeons
Surgery
Trauma
title Comparative Analysis between Three Different Lumbar Decompression Techniques (Microscopic, Tubular, and Endoscopic) in Lumbar Canal and Lateral Recess Stenosis: Preliminary Report
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