Artikel
Decompression of degenerative lateral spinal stenosis in a full-endoscopic transforaminal and interlaminar technique using new endoscopes and instruments
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Veröffentlicht: | 13. Juni 2005 |
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Gliederung
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Purpose
Surgical therapy of lumbar spinal canal stenosis aims at sufficient decompression with reduction of operation-induced traumatization and destabilization. The objective of this prospective study was to assess a full-endoscopic technique for surgery of degenerative lateral spinal canal stenosis.
Materials and Methods
61 patients were operated in 2003. Inclusion criteria were: one-sided neurogenic claudication, monosegmental lateral recessus stenosis, spondylolisthesis max. Meyerding Grade I, scoliosis less than 20°. The operation was performed full-endoscopically with 7-mm endoscopes with 4-mm intraendoscopic work channel. Specific anatomical criteria for using the interlaminar or lateral transforaminal approach were given. The follow-up time lasted from 12 to 19 months. 57 patients (93 %) were included in the follow-up.
Results
The planned operation was technically feasible in all cases. No serious complications occurred. The mean operation time was 43 minutes. There was no measurable blood loss. The max. hospital stay was 4 days. 47 patients (82 %) reported no further radicular leg pain, 7 patients (13 %) occasional pain. 3 patients (5 %) experienced no improvement and underwent conventional revision. No increasing instability could be determined radiologically. All results remained constant.
Conclusion
Within the prescribed narrow indication criteria, the method described is technically possible. It enables a more selective procedure with visualization of the recessus without extensive resection of bone structures. Based on early results, decompression is found to be sufficient and free of complications, while offering the advantages of a truly minimal-invasive procedure. Further studies will be conducted to answer the question of recurrence and stability.