脊柱杂志

Microendoscopic Posterior Decompression for the Treatment of Lumbar Lateral Recess Stenosis

Abstract

Akihiko Hayashi, Yasushi Oshima, Ryutaro Shiboi, Satoshi Baba, Yuichi Takano, Hirohiko Inanami and Hisashi Koga

Lateral recess stenosis (LRS) is a characteristic type of lumbar spinal canal stenosis, with symptoms of nerve root compression. The most common etiology is hypertrophy of the superior articular process. Conventional laminectomy and medial facetectomy are commonly used to treat LRS. This study investigated microendoscopic posterior decompression for the treatment of LRS. Microendoscopic decompression was performed on 28 patients. Computed tomography and magnetic resonance imaging were used to calculate the lateral recess angle and depth. A 16 mm diameter tubular retractor and endoscopic system were used. Unilateral paramedian approaches were performed in all patients. Even using a unilateral paramedian approach, both sides of the nerve roots were decompressed in patients with bilateral radiculopathy. Preand postoperative status was evaluated using the visual analogue scale (VAS). Patient’s mean age was 62.9 years; there was single-level involvement, mostly at L4-5 (85.7%). Intraoperative findings revealed that the most common cause of nerve root compression was hypertrophy of the superior articular process and ligamentum flavum. VAS score improved in all patients following posterior decompression. Pre- and postoperative mean VAS scores were 6.5 and 1.1, respectively (P value < 0.01). No intra- or postoperative complications were observed during a mean follow-up of 10.5 months.