Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis
Authors:
- Ko IkutaKIKo Ikuta
- Junichi ArimaJAJunichi Arima
- Takayuki TanakaTTTakayuki Tanaka
- Masayoshi OgaMOMasayoshi Oga
- Soichiro NakanoSNSoichiro Nakano
- Kosuke SasakiKSKosuke Sasaki
- Kohei GoshiKGKohei Goshi
- Masaki YoMYMasaki Yo
- Shingo FukagawaSFShingo Fukagawa
- 1 May 2005
- journal article
- clinical trial
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery: Spine
- Vol. 2 (5) , 624-633
Abstract
Object. The authors applied the technique of microendoscopic discectomy to posterior decompression procedures for lumbar spinal stenosis. The purpose of this study was to determine the feasibility of using an endoscopic technique to treat lumbar spinal stenosis and to evaluate the clinical and radiographic results of microendoscopic posterior decompression (MEPD). Methods. Microendoscopic posterior decompression, which involves a unilateral endoscopic approach for bilateral decompression, was performed in 47 patients. Clinical and radiographic/neuroimaging results were evaluated during the follow-up period (minimum duration 1 year). The clinical results were compared with those of the conventional laminotomy. Radiographic instability and the degree of surgical invasion of the facet joints were evaluated. In a control a group of 29 patients open laminotomy was performed. The clinical outcome was evaluated in 44 patients. The mean follow-up duration was 22 months. The mean rate of improvement was 72% based on the Japanese Orthopaedic Association score, and good results were obtained in 38 patients. Although the rate of morbidity decreased in the MEPD group, the incidence of complication was slightly higher. Effective decompression was demonstrated in the majority of the patients by using magnetic resonance imaging. Radiographic instability appeared in one patient postoperatively, and based on computerized tomography scanning, a tendency toward invasion of the facet joint on the approach side was noted. Conclusions. Microendoscopic posterior decompression is a minimally invasive procedure and is as useful as other conventional procedures in treating lumbar spinal stenosis; however, a few technical problems remain to be solved.Keywords
This publication has 22 references indexed in Scilit:
- Patient Outcomes After Minimally Destabilizing Lumbar Stenosis DecompressionSpine, 2000
- Seven- to 10-year Outcome of Decompressive Surgery for Degenerative Lumbar Spinal StenosisSpine, 1996
- Role of Ligaments and Facets in Lumbar Spinal StabilitySpine, 1995
- Long-Term Results of Surgical Treatment of Lumbar Spinal StenosisSpine, 1993
- Local Denervation Atrophy of Paraspinal Muscles in Postoperative Failed Back SyndromeSpine, 1993
- Biomechanical Evaluation of Lumbar Spinal Stability After Graded FacetectomiesSpine, 1990
- Comparison of CT Scan Muscle Measurements and Isokinetic Trunk Strength in Postoperative PatientsSpine, 1989
- Postoperative Instability After Decompression for Lumbar Spinal StenosisSpine, 1986
- Lumbar Spinal Instability (Olisthesis) After Extensive Posterior Spinal DecompressionSpine, 1983
- The Resistance to Flexion of the Lumbar Intervertebral JointSpine, 1980