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Percutaneous transforaminal endoscopic decompression with removal of the posterosuperior region underneath the slipping vertebral body for lumbar spinal stenosis with degenerative lumbar spondylolisthesis: a retrospective study – Lumbar Spinal Stenosis

The article discusses a study on percutaneous transforaminal endoscopic decompression (PTED) combined with the removal of the posterosuperior region underneath the slipping vertebral body (PRSVB) for the treatment of lumbar spinal stenosis (LSS) with degenerative lumbar spondylolisthesis (DLS). A total of 44 patients underwent this procedure and were followed up for at least 12 months. The study found that the procedure led to significant improvements in clinical outcomes, with the majority of patients reporting good or excellent results according to the modified MacNab criteria. While there were some minor complications reported, the study suggests that increasing the removal of PRSVB during PTED may be beneficial for alleviating symptoms in patients with LSS and DLS, although long-term follow-up is needed to fully evaluate the effects

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: Increasing the removal of PRSVB during the PTED process may be a beneficial surgical procedure for alleviating clinical symptoms in patients with LSS and DLS. However, long-term follow-up is needed to study clinical effects.

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BMC Musculoskelet Disord. 2024 Feb 20;25(1):161. doi: 10.1186/s12891-024-07267-7.ABSTRACTBACKGROUND: Percutaneous transforaminal endoscopic decompression (PTED) is an ideal minimally invasive decompression technique for the treatment of lumbar spinal stenosis (LSS) with degenerative lumbar spondylolisthesis (DLS). The posterosuperior region underneath the slipping vertebral body (PRSVB) formed by DLS is an important factor exacerbating LSS in patients. Therefore, the,

BMC Musculoskelet Disord. 2024 Feb 20;25(1):161. doi: 10.1186/s12891-024-07267-7.

ABSTRACT

BACKGROUND: Percutaneous transforaminal endoscopic decompression (PTED) is an ideal minimally invasive decompression technique for the treatment of lumbar spinal stenosis (LSS) with degenerative lumbar spondylolisthesis (DLS). The posterosuperior region underneath the slipping vertebral body (PRSVB) formed by DLS is an important factor exacerbating LSS in patients. Therefore, the necessity of removing the PRSVB during ventral decompression remains to be discussed. This study aimed to describe the procedure of PTED combined with the removal of the PRSVB and to evaluate the clinical outcomes.

METHODS: LSS with DLS was diagnosed in 44 consecutive patients at our institution from January 2019 to July 2021, and they underwent PTED combined with the removal of the PRSVB. All patients were followed up for at least 12 months. The clinical outcomes were evaluated using the visual analog scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria.

RESULTS: The mean age of the patients was 69.5 ± 7.1 years. The mean preoperative ODI score, VAS score of the low back, and VAS score of the leg were 68.3 ± 10.8, 5.8 ± 1.0, and 7.7 ± 1.1, respectively, which improved to 18.8 ± 5.0, 1.4 ± 0.8, and 1.6 ± 0.7, respectively, at 12 months postoperatively. The proportion of patients presenting “good” and “excellent” ratings according to the modified MacNab criteria was 93.2%. The percent slippage in spondylolisthesis preoperatively (16.0% ± 3.3%) and at the end of follow-up (15.8% ± 3.3%) did not differ significantly (p>0.05). One patient had a dural tear, and one patient had postoperative dysesthesia.

CONCLUSIONS: Increasing the removal of PRSVB during the PTED process may be a beneficial surgical procedure for alleviating clinical symptoms in patients with LSS and DLS. However, long-term follow-up is needed to study clinical effects.

PMID:38378495 | DOI:10.1186/s12891-024-07267-7

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Percutaneous transforaminal endoscopic decompression with removal of the posterosuperior region underneath the slipping vertebral body for lumbar spinal stenosis with degenerative lumbar spondylolisthesis: a retrospective study

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BMC Musculoskelet Disord. 2024 Feb 20;25(1):161. doi: 10.1186/s12891-024-07267-7.ABSTRACTBACKGROUND: Percutaneous transforaminal endoscopic decompression (PTED) is an ideal minimally invasive decompression technique for the treatment of lumbar spinal stenosis (LSS) with degenerative lumbar spondylolisthesis (DLS). The posterosuperior region underneath the slipping vertebral body (PRSVB) formed by DLS is an important factor exacerbating LSS in patients. Therefore, the

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