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Chinese Journal of Clinicians(Electronic Edition) ›› 2019, Vol. 13 ›› Issue (11): 801-805. doi: 10.3877/cma.j.issn.1674-0785.2019.11.001

Special Issue:

• Clinical Research •     Next Articles

Treatment of lumbar spinal stenosis by full-endoscopic trephination-based bilateral decompression via a unilateral approach

Mengjiao Xia1, Zhenfei Wang1, Tao Chen2, Meng Zhao1, Jian Zhou1, Chao Ma1, Juan Gao1, Kun Liu3, Xinhua Qu3, Kerong Dai3, Guangwang Liu1,()   

  1. 1. Department of Spine Surgery, Xuzhou Central Hospital, Xuzhou 221000, China
    2. Bengbu Medical College, Bengbu 233000, China
    3. Bone and Joint Institute, Shanghai Jiao tong University School of Medicine, Shanghai 200000, China
  • Received:2018-12-15 Online:2019-06-01 Published:2019-06-01
  • Contact: Guangwang Liu
  • About author:
    Corresponding author: Liu Guangwang, Email:

Abstract:

Objective

To investigate the feasibility and efficacy of full-endoscopic trephination-based bilateral decompression via a unilateral approach in the treatment of lumbar spinal stenosis (LSS).

Methods

From September 2015 to September 2017, 31 cases of LSS were treated by full-endoscopic trephination-based bilateral decompression via a unilateral approach. The operative time, intraoperative blood loss, postoperative complications, and CT reexamination findings were recorded, the efficacy was evaluated according to the Nakai standard at the last follow-up, and the excellent/good result rate was calculated.

Results

The operation time ranged from 65 to 125 min, with an average of (48±13) min. Intraoperative blood loss ranged from 25 to 180 ml, with an average of (37±9) ml. The incision length was about 7-8 mm, with an average of (7.0±0.6) mm. All the operations were successfully completed without complications such as nerve injury, postoperative infection, and lumbar instability. Postoperative CT showed adequate decompression of the spinal canal. The patients were followed for 6 to 18 months, with an average period of (10.0±4.6) months. With regard to curative effects, excellent, good, fair, and poor results were achieved in 22, 6, 2, and 1 case, respectively, with an excellent/good result rate of 90.3% (28/31).

Conclusion

Full-endoscopic trephination-based bilateral decompression via a unilateral approach in the treatment of LSS is associated with adequate decompression, small trauma, quick recovery, low cost, high safety, and low incidence of postoperative complications, and can minimize damage to the lumbar spinal structure, representing an ideal minimally invasive procedure for the treatment of LSS.

Key words: Spinal stenosis, Spine endoscopy, Trephination

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