Bilateral decompression and intervertebral fusion by way of unilateral fenestration for complicated lumbar spinal stenosis with a cell microendoscopic method.
Drugs (Baltimore). 2018 Jan;97(four):e9715
Authors: Xu B, Xu H, Ma X, Liu Y, Yang Q, Jiang H, Li N, Ji N
For complicated lumbar spinal stenosis, utilizing of endoscopy method might present clear imaginative and prescient with much less invasive dissection of paravertebral muscle. The target of this research was to judge the feasibility and medical efficacy of bilateral decompression and intervertebral fusion by way of unilateral fenestration for complicated lumbar spinal stenosis utilizing cell microendoscopic discectomy (MMED) method.A complete of 61 sufferers with complicated lumbar spinal stenosis (lumbar canal stenosis mixed with degenerative spondylolisthesis, instability, and scoliosis) had been handled with this process. Sufferers with remoted lumbar spinal stenosis or spondylolisthesis better than grade II had been excluded. The index ranges included L4/5 in 52 sufferers, L5/S1 in 6 sufferers, L3-L5 in 2 sufferers and L4-S1 in 1 affected person. The preoperative Oswestry Incapacity Index (ODI) rating was 42.6?±?10.2, lumbar visible analog scale (VAS) rating was 6.1?±?four.2, and leg VAS rating was 7.1?±?5.1. In the course of the operation, ipsilateral enlarged fenestration was made utilizing the MMED method. The disc and cartilage endplate had been totally eliminated, and the contralateral ligamentum flavum and the internal layer of lamina had been undercut to launch the contralateral nerve root. The intervertebral house was launched and ready, by bone grafting and cage insertion. Percutaneous pedicle system was used for discount and fixation. The operative time and blood loss had been recorded, and sufferers had been followed-up for not less than three years (36-48 months, common 41 months) to judge the medical efficacy.The process was profitable in all sufferers, with no nerve damage or conversion to open operation. The imply operative time was 120?minutes (vary, 100-180?minutes), with a imply blood lack of 100 mL (vary, 50-200 mL). Postoperative x-ray and CT confirmed enough decompression and enchancment of spinal alignment. At three years after surgical procedure, the ODI scores, lumbar and leg VAS scores decreased from preoperative 42.6?±?10.2, 6.1?±?four.2, and seven.1?±?5.1 to eight.6?±?7.zero, 1.eight?±?1.three, and zero.9?±?zero.6, respectively (P?=?.00 for every comparability). The medical outcomes had been glorious in 36 instances, good in 23, and truthful in 2, in line with the MacNab scale.The process of bilateral decompression and intervertebral fusion by way of unilateral fenestration utilizing the MMED method can present passable medical outcomes for complicated lumbar spinal stenosis.
PMID: 29369203 [PubMed – in process]