Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal Lesions.
Asian Backbone J. 2018 Apr;12(2):246-255
Authors: Ikuta Ok, Kitamura T, Masuda Ok, Hotta Ok, Senba H, Shidahara S
Research Design: Retrospective examine.
Objective: This examine aimed to guage the efficacy of minimally invasive transtubular endoscopic decompression for the therapy of lumbosacral extraforaminal lesion (LSEFL).
Overview of Literature: Typical procedures for surgical decompression for the therapy of LSEFL contain sure technical challenges as a result of the lumbosacral extraforaminal area has distinctive anatomical options. Furthermore, the efficacy of minimally invasive procedures carried out through the posterolateral strategy for LSEFL has been reported.
Strategies: Twenty-five sufferers who had undergone minimally invasive transtubular endoscopic decompression for the therapy of LSEFL and might be adopted up for not less than 1 yr postoperatively have been enrolled. 5 of those sufferers had a historical past of lumbar surgical procedure, and 7 had concomitant adjacent-level spinal stenosis. The scientific outcomes have been evaluated utilizing the Japanese Orthopaedic Affiliation (JOA) lumbar rating, numeric score scale (NRS), and the JOA Again Ache Analysis Questionnaire (JOABPEQ). The imply postoperative follow-up (FU) period was three.eight years.
Outcomes: All procedures might be accomplished with none extreme surgical issues, and all sufferers might resume their earlier exercise degree inside 1 month postoperatively. The JOA rating considerably elevated from 14.1±four.zero at baseline to 23.1±three.7 on the 1-year FU and 22.1±three.eight on the final FU. Equally, there have been vital enhancements within the postoperative NRS and JOABPEQ scores. An extra surgical procedure was carried out in two sufferers (eight%) through the FU interval. Sufferers with degenerative scoliosis exhibited considerably poorer outcomes in contrast with these with out this situation.
Conclusions: Transtubular endoscopic decompression can overcome sure technical challenges concerned within the standard procedures for LSEFL therapy; subsequently, it may be advisable as a helpful process for treating LSEFL. This process can present some advantages to LSEFL sufferers and supply a well-illuminated surgical area and excessive surgical security for the surgeon. Nonetheless, the process ought to be rigorously tailored for LSEFL sufferers with concomitant degenerative scoliosis.
PMID: 29713405 [PubMed]