Bilateral decompression in lumbar degenrative stenosis associated with unilateral approach under minimally invasive microendoscopy(METRx) / 中华显微外科杂志

ABSTRACT

Object To discuss the surgical techniques and the clinical outcomes of the bilateral microendoscopic decompression surgery for lumbar spinal canal and lateral recess stenosis through unilateral approach. Methods 18-ram-diameter microendoscopic tubular retractor was placed with fluoroscopic gnidance, bilateral microendoscopic decompression surgery for lumbar spinal stenosis through unilateral approach were managed by adjusting the angle of tubular retractor. During the procedure, supra-interspinal ligament and contralateral bony lamina were well preserved. Results In the group of single-level microendoscopicdecompression, the mean operation time was 94 min and the mean blood loss was 65 ml. In the group of twolevel microendoscopic decompression, the mean operation time was 135 rain and the mean blood loss was 90 ml. The mean bed rest time was 6.5 days. After operation, the average back pain VAS score decreased from 6.5 to 3.1, the average leg pain VAS score decreased from 7.2 to 2.2, the average Oswestry Disability Index (ODI) decreased from 46.8 to 24.6, which had shown significant statistical difference before and after surgery (P ＜ 0.05). According to Nakai criteria, the excellent and good rate was 84%. Conclusion Bilateral microendoscopic decompression of lumbar canal through unilateral approach under METRx system offers a save, effective and minimal invasive option for lumbar spinal stenosis.