Surgical Outcomes of Full-Endoscopic Degenerative Lumbar Lateral Recess Stenosis Decompression Through an Interlaminar Approach.

Abstract

Objective: The conventional open decompression surgery for degenerative lumbar lateral recess stenosis (DLLRS) yields definitive therapeutic outcomes; however, it confronts numerous challenges, including extensive surgical trauma and iatrogenic spinal instability. The purpose of this study is to investigate the surgical outcomes of full-endoscopic DLLRS decompression by an interlaminar approach.

Methods: A consecutive cohort of 275 patients, including 148 males and 127 females, with an average age of 64.62 (55-82) years, with DLLRS between July 2021 and December 2022, was reviewed in this retrospective study. The involved segments were L4/5 in 126 patients and L5/S1 in 149 patients. The computed tomography (CT) and magnetic resonance imaging (MRI) of the lumbar were examined before and after surgery to evaluate the degree of decompression. The VAS score of back and leg pain and the ODI scale were recorded preoperatively, 1 day, 1, 3, 6, and 12 months after surgery, and at the last follow-up. The modified Macnab score was determined at the last follow-up. One-way analysis of variance (ANOVA) was used to compare the VAS and ODI scores of back/leg pain at various time points before and after surgery.

Results: All of the patients underwent surgery successfully. The average duration of surgery was 84.90 min, the average blood loss was 47.33 mL, and the length of hospitalization was 3-4 (3.31 ± 0.46) days, with no nerve injury, infections, or other complications. One-way ANOVA results showed significantly improved VAS and ODI scores for back/leg pain at each time point after surgery compared to those preoperatively (p < 0.05). The mean follow-up was 23.6 ± 2.3 (range, 15-32) months; at the last follow-up, the modified Macnab was excellent in 143 patients, good in 102 patients, fair in 18 patients, and poor in 12 patients.

Conclusion: Full-endoscopic lumbar lateral recess decompression through an interlaminar approach is a safe and effective approach for DLLRS.