Article
Endoscopic cervical and lumbar spine surgery – clinical results of a consecutive series of 260 patients with a mean follow-up of 52 month
Endoskopische zervikale und lumbale Wirbelsäulenchirurgie – klinische Ergebnisse einer konsekutiven Serie von 260 Patienten mit einem mittleren Verlaufsuntersuchungszeitraum von 52 Monaten
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Authors
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Benedikt Burkhardt
- Universität des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
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Joachim Oertel
- Universität des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
| Published: | June 26, 2020 |
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Outline
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Objective: The primary idea of endoscopic spine surgery (ESS) was to reduce muscle trauma. In this work the authors present their experience in ESS for the treatment of cervical and lumbar degenerative disorders.
Methods: Clinical data about neck and back pain, arm and leg pain, intra-and perioperative complication, and reoperation was prospectively collected for all patients who underwent ESS over the past 10 years. All patients who underwent ESS via a paramedian approach for degenerative cervical or lumbar disorders who were followed for at least 3 month postoperatively were inlcuded for further final follow-up assessement. At final follow-up a personal examination and a standardized questionnaire was performed including the Oswestry disability index (ODI), neck disability index (NDI), and the modified MacNab/Odoms Criteria.
Results: A total of 319 out of 502 patients fullfilled inclusion criteria, and 260 out of those 319 patients attended the final follow-up examination (82%). Sixty patients underwent ESS for posterior cervical foraminotomy (PCF), 18 for lumbar synovial cyst (LSC), 66 for decompression of lateral recess (LRS) or central canal stenosis (LSS), and 116 for lumbar disc herniation (LDH). The mean follow-up was 52 months. The rate for radicular pain relief in LDH, LSC, LRS/LSS and PCF procedure were 92%, 90%, 93%, and 86% respectively. No weakness was documented in 85% of lumbar and 86% cervical spine cases. The mean ODI was 14.0% and mean NDI was 12%. According to MacNab/Odoms criteria clinical success was noted in 91% and 89%, respectively. The dural tear rate varied from 1.1% in LDH to 21% in LSC procedures and all were closed endoscopically. The recurrent disc herniation rate was 6.1%. The mean surgical time decreased from 71 to 54 minutes.
Conclusion: ESS is a safe and effective technique to treat degenerative cervical and lumbar spine disorders. The rates for pain relief, clinical success, intraoperative complication, and reoperation are similar to established open procedures.
