YAO Xingwang,LI Yawei,WANG Bing.Clinical analysis of lumbar lateral recess stenosis with the full-endoscopic visualized decompression via a superior vertebral notch approach[J].Chinese Journal of Spine and Spinal Cord,2020,(7):589-595.
Clinical analysis of lumbar lateral recess stenosis with the full-endoscopic visualized decompression via a superior vertebral notch approach
Received:March 16, 2020  Revised:April 11, 2020
English Keywords:Lateral recess stenosis  Superior vertebral notch approach  Full-endoscopic  Visualized
Fund:国家自然科学基金青年基金(81601868);湖南省自然科学基金青年项目(2018JJ3572)
Author NameAffiliation
YAO Xingwang Departmnet of Spine Surgery, the Second Xiangya Hospital of Central South University, Changsha, 410011, China 
LI Yawei 中南大学湘雅二医院脊柱外科 410011 湖南省长沙市 
WANG Bing 中南大学湘雅二医院脊柱外科 410011 湖南省长沙市 
吕国华  
戴瑜亮  
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English Abstract:
  【Abstract】 Objectives: To evaluate the clinical outcomes and key points of the full-endoscopic(FE) visualized decompression via a superior vertebral notch approach for the treatment of lumbar lateral recess stenosis. Methods: 96 cases with lumbar lateral recess stenosis that underwent the FE visualized decompression via a superior vertebral notch approach from June 2016 to December 2017 in our hospital were enrolled. There were 62 males and 34 females, with an average age of 51.4±13.3 years(38-68 years). The preoperative visual analog scale(VAS) scores of low back pain and leg pain were 0-5(3.8±1.6) and 3-7(5.2±1.0), respectively. The preoperative Oswestry disability index(ODI) was 38%-65%[(53.0±9.1)%]. The preoperative angle and anteroposterior diameter of the lateral recess were 17.6°±1.4° and 2.3±0.2mm, respectively. All patients were followed up for 2 years at least. The VAS scores of low back pain and leg pain, and lumbar ODI were evaluated and analyzed at 1 week, 3 months, 1 year and final follow-up postoperatively. The surgical effectiveness was assessed according to the modified MacNab criteria at final follow-up. Results: 96 cases were successfully completed the operation. The average operation time was 55.8±14.6min; the average times of radiation was 7.2±2.5; the average length of hospital stay was 3.7±1.9 days. One case occurred temporary paralysis who recovered after a conservative treatment within 1 week. 6 cases remained residual symptoms, and 4 cases didn′t show any improvement after surgery. 6 cases had to undergo revision surgery finally. The postoperative angle and anteroposterior diameter of the lateral recess were 39.5°±4.2° and 6.2±0.4mm, significantly increased comparing with pre-operation(P<0.01). The postoperative VAS scores for low back and leg pain, as well as the ODI at 1 week, 3 months, 1 year and final follow-up were obviously improved when compared with pre-operation(P<0.05). All patients were followed up, the follow-up time was 24-32 months(26.6±5.6 months). Based on the modified MacNab scores at final follow-up, 32 cases were classified as excellent; 54 cases were good; 6 cases were fair; 4 cases were poor, with 89.6% of the satisfactory rate. Conclusions: The FE visualized decompression via a superior vertebral notch approach is an effective and safe surgery for lumbar lateral recess stenosis and is able to achieve satisfactory short-term results. However, the indications need to be strictly selected, to avoid affecting the improvement of clinical outcomes.
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