Kosuke Sugiura, Cathryn Payne, Nguyen T Tran, Jannik Leyendecker, John Ogunlade, Mary LaVanne, Peter B Derman, Robert Quon, Albert E Telfeian, Christoph P Hofstetter
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引用次数: 0
Abstract
Background and objectives: Full-endoscopic surgery is increasingly used for treating lumbar foraminal pathologies, though the specific indications remain unclear. This study aims to evaluate patient-reported outcomes after transforaminal full-endoscopic spine surgery for various lumbar foraminal conditions.
Methods: Multicenter cohort study of patients with intervertebral lumbar foraminal pathology who underwent full-endoscopic decompression at four medical centers. Postoperative patient-reported outcomes, including low back and leg pain as well as Oswestry Disability Index (ODI) scores, were prospectively tracked using a mobile app for 6 months. Six-month outcome measures (patient-reported outcome measures) were used as the primary outcome variable to determine treatment effectiveness regarding various foraminal pathologies.
Results: A total of 83 patients with a mean age of 57.04 ± 1.63 years were included. The most common operative levels were L4/5 for transforaminal endoscopic discectomies (59.6%) and L5/S1 for endoscopic foraminotomies (58.1%). Endoscopic discectomies resulted in significant improvements in Visual Analog Scale scores for low back pain (from 5.85 ± 0.43 to 3.02 ± 0.41; P < .001), leg pain (from 6.66 ± 0.34 to 3.12 ± 0.57; P < .001), and ODI scores (from 24.39 ± 1.35 to 12.32 ± 176; P < .001). Endoscopic foraminotomies also resulted in significant improvements in Visual Analog Scale scores for low back pain (from 5.58 ± 0.53 to 3.68 ± 0.58; P < .001) and leg pain (from 6.42 ± 0.47 to 4.21 ± 0.58; P < .001), as well as ODI scores (from 19.28 ± 1.41 to 14.67 ± 2.03; P < .01). The amount of improvement was independent of the severity of foraminal stenosis, as determined on preoperative MRI. However, vertical foraminal stenosis was associated with the lowest treatment response rate.
Conclusion: Endoscopic foraminotomies result in clinically meaningful symptomatic improvement for most lumbar foraminal pathologies. However, the effectiveness of decompression surgery for vertical foraminal stenosis is limited and requires further investigation.
期刊介绍：
Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery.
Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.
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