Treatment of lumbar canal stenosis by a microscopic assisted percutaneous approach

ABSTRACT

Prospective study on the efficacy of a microscopically assisted less invasive approach for the operative treatment of lumbar canal stenosis. Less invasive techniques e.g. percutaneous endoscopic and microscopic assisted procedures play now an important role in spine surgery. The advantage of these techniques is to minimize the surgical trauma and accordingly the surgical stress to which the patient is subjected. This is valuable in elderly patients, as lumbar canal stenosis is usually associated with other systemic diseases that add risk to the operative intervention. The aim of this study is to evaluate the efficacy of this minimal invasive approach as an alternative for the operative treatment of lumbar canal stenosis. 50 consecutive patients with a mean age of 72.26 years were operated upon using this technique. The study included 70 lumbar segments. The mean follow up period was 21.58 months. The Visual Analogue Scale [VAS] for back and leg pain together with Oxford Claudication Score [OCS] were used to assess the patients pre-operatively as well as post-operatively. The average operative time for one level decompression was 81 minutes and the average blood loss was 50 ml/patient. Three patients [6%] were revised by open surgery. The OCS showed statistically significant improvement from 28.84 pre-operatively to 14.8 post-operatively [p<0.0001]. VAS for back pain and leg pain showed also statistically significant improvement [p < 0.0001]. This percutaneous technique is effective in decompressing lumbar canal stenosis. It carries the advantage of early mobilization and rehabilitation especially in elderly patients