Conceptual development of lateral approach percutaneous spinal endoscopy / 西安交通大学学报(医学版)

Lateral approach percutaneous spinal endoscopy， one of the most representative spinal endoscopic procedures， has ranked among the mainstream spinal operations that are facilitated to be understood and mastered by surgeons. The surgeries possess advantages of precise curative effect and wide scope of application after a series of conceptual innovations and reforms including YESS technology， TESSYS technology， eccentric trepan technology， visualized plasty technology， full-endoscopic visualization technology， and spinal endoscopy technology from the perspective of open surgery. Moreover， lateral approach percutaneous spinal endoscopy has formed a technology cluster that is inclusive with broad development prospects based on the introduction of high-tech technologies such as artificial intelligence and various navigation technologies.

PEID with bone-chisel technique in the treatment of unilateral lumber lateral recess stenosis: A curative effect study in elderly patients / 西安交通大学学报(医学版)

【Objective】 To investigate the effect of decompression technique with bone-chisel under percutaneous spinal endoscopy through transforaminal approach in elderly patients with unilateral lateral recess stenosis （ULLRS）. 【Methods】 We enrolled 46 old patients with ULLRS who underwent percutaneous spinal endoscopy through transforaminal approach assisted with bone-chisel technique from March 2017 to July 2019. The visual analogue scale （VAS） score of low back pain and leg pain， the Oswestry dysfunction index （ODI）， and the modified MacNab score before and after operation were obtained. We also recorded preoperative and postoperative sagittal diameter measured by computer tomography （CT） to evaluate decompression of the lateral recess. All the patients were followed up for at least 1 year for complications. 【Results】 All the 46 patients were followed up for 17 to 42 months. Dural tear occurred in one case， transient nerve root irritation in two cases， and there were no other complications. The low back pain VAS score， lower limb pain VAS score， and ODI index of all the patients were significantly improved in the last follow-up （P<0.05）. The results of the modified MacNab efficacy evaluation at the last follow-up revealed that the excellent and good rate was 91.3% （excellent in 38， good in 4， and fair in 4）. The sagittal diameter （mm） of the bony lateral recess 1 year after surgery increased by an average of 55.8%， which was significantly better than that before surgery （t=6.354， 4.22±1.25 vs. 2.71±0.57， P<0.001）. 【Conclusion】 Percutaneous spinal endoscopy through transforaminal foramen approach combined with bone-chisel technique is effective in treating ULLRS in elderly patients.