Bilateral decompression and intervertebral fusion through unilateral fenestration for advanced 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 advanced lumbar spinal stenosis, utilizing of endoscopy method could present clear imaginative and prescient with much less invasive dissection of paravertebral muscle. The target of this examine was to guage the feasibility and medical efficacy of bilateral decompression and intervertebral fusion through unilateral fenestration for advanced lumbar spinal stenosis utilizing cell microendoscopic discectomy (MMED) method.A complete of 61 sufferers with advanced lumbar spinal stenosis (lumbar canal stenosis mixed with degenerative spondylolisthesis, instability, and scoliosis) have been handled with this process. Sufferers with remoted lumbar spinal stenosis or spondylolisthesis better than grade II have 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. Throughout the operation, ipsilateral enlarged fenestration was made utilizing the MMED method. The disc and cartilage endplate have been totally eliminated, and the contralateral ligamentum flavum and the inside layer of lamina have been undercut to launch the contralateral nerve root. The intervertebral area 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 have been recorded, and sufferers have been followed-up for not less than three years (36-48 months, common 41 months) to guage the medical efficacy.The process was profitable in all sufferers, with no nerve harm 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 ample 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 have been glorious in 36 circumstances, good in 23, and truthful in 2, in line with the MacNab scale.The process of bilateral decompression and intervertebral fusion through unilateral fenestration utilizing the MMED method can present passable medical outcomes for advanced lumbar spinal stenosis.
PMID: 29369203 [PubMed – in process]