Preliminary study on lumbar spinal canal stenosis treated by microendoscopic unilateral approach and bilateral decompression / 中国矫形外科杂志

ABSTRACT

[Objective]To evaluate the clinical outcome of lumbar spinal canal stenosis treated by microendoscopic decompressive laminotomy with facet-preserving technique.[Method]Twenty-nine consecutive patients of posterior lumbar spinal canal stenosis were treated by microendoscopic unilateral approach and bilateral decompression with facet-preserving technique using the METRxTM microendoscopic spinal system.Moreover,operation time,blood loss,use of diclofenac suppositories,intra-and postoperative complications and Imaging evaluation were investigated.Clinical outcomes were evaluated by the Japanese Orthopaedic Association scoring system for lumbar disease.[Result]Twenty-four patients were followed up for 7 to 24 months,mean 15.3 months.Mean preoperative JOA scores were(14.5?3.7),and postoperative JOA scores were(22.4?2.3).The mean recovery rate was 54.7%.Operation time was 94.2 minutes for one level decompression,and mean blood loss was 56.4 ml.The use of diclofenac suppositories was average 0.37 times.Intra and postoperative complications were due to one misjudgment of the vertebral level,one dural tears.Intraoperative endoscopic photograph showed satisfactory decompression of dural sac and contralateral nerve root from ipsilateral laminotomy could be performed completely.Postoperative CT and 3DCT showed bilateral decompression from ipisilateral laminotomy and revealed no damage of the facet joints.[Conclusion]Microendoscopic unilateral approach and bilateral decompression with facet-preserving technique using the METRxTM microendoscopic spinal system minimizes resection of the pathologic compression tissues and is a safe,effective and ideal decompressive method for lumbar spinal canal stenosis.