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Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results
OBJECTIVE: Interlaminar endoscopic spine surgery has been introduced and utilized for lumbar lateral recess decompression. We modified this technique and utilized it for bilateral lateral recess stenoses without significant central stenosis. Here we present the surgical details and clinical outcome...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Spinal Neurosurgery Society
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816588/ https://www.ncbi.nlm.nih.gov/pubmed/36597639 http://dx.doi.org/10.14245/ns.2244344.172 |
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author | Kwon, Woo-Keun Kelly, Katherine A. McAvoy, Malia Sivakanthan, Sananthan Ogunlade, John Yap, Natalie Kai Yi Durfy, Sharon Hofstetter, Christoph P. |
author_facet | Kwon, Woo-Keun Kelly, Katherine A. McAvoy, Malia Sivakanthan, Sananthan Ogunlade, John Yap, Natalie Kai Yi Durfy, Sharon Hofstetter, Christoph P. |
author_sort | Kwon, Woo-Keun |
collection | PubMed |
description | OBJECTIVE: Interlaminar endoscopic spine surgery has been introduced and utilized for lumbar lateral recess decompression. We modified this technique and utilized it for bilateral lateral recess stenoses without significant central stenosis. Here we present the surgical details and clinical outcome of ligamentum flavum sparing unilateral laminotomy for bilateral recess decompression (ULBRD). METHODS: Prospectively collected registry for full-endoscopic surgeries was reviewed retrospectively. One hundred eighty-two consecutive cases from a single center between September 2015 and March 2021 were reviewed and 57 of them whom underwent ULBRD were enrolled for analysis. Basic patient demographic data, perioperative details, surgeryrelated complications, and clinical outcome were reviewed. The detailed surgical technique is presented as well. RESULTS: Among the 57 patients enrolled, 37 were males while the other 20 were females. The mean age was 58.53 ± 14.51 years, and a bimodal age distribution at the age of mid-fifties and mid-sixties or older was noted. The later age-peak was related to coexistence of degenerative scoliosis. The average operative time per lamina was 70.34 ± 20.51 minutes and mean length of stay was 0.56 ± 0.85 days. Four perioperative complications were reported (7.0%) and the overall reoperation rate at the index level within 1 year was 8.8%. The preoperative back/leg visual analogue scale scores and functional outcome scales including EuroQol-5 dimension questionnaire, Oswestry Disability Index presented significant improvement immediately after surgery and were maintained until final follow-up. CONCLUSION: ULBRD for bilateral lateral recess stenoses without significant central stenosis resulted in good clinical outcomes with acceptably low perioperative complications rates. Sufficient decompression was achieved with the central ligamentum flavum being preserved. |
format | Online Article Text |
id | pubmed-9816588 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Korean Spinal Neurosurgery Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-98165882023-01-11 Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results Kwon, Woo-Keun Kelly, Katherine A. McAvoy, Malia Sivakanthan, Sananthan Ogunlade, John Yap, Natalie Kai Yi Durfy, Sharon Hofstetter, Christoph P. Neurospine Original Article OBJECTIVE: Interlaminar endoscopic spine surgery has been introduced and utilized for lumbar lateral recess decompression. We modified this technique and utilized it for bilateral lateral recess stenoses without significant central stenosis. Here we present the surgical details and clinical outcome of ligamentum flavum sparing unilateral laminotomy for bilateral recess decompression (ULBRD). METHODS: Prospectively collected registry for full-endoscopic surgeries was reviewed retrospectively. One hundred eighty-two consecutive cases from a single center between September 2015 and March 2021 were reviewed and 57 of them whom underwent ULBRD were enrolled for analysis. Basic patient demographic data, perioperative details, surgeryrelated complications, and clinical outcome were reviewed. The detailed surgical technique is presented as well. RESULTS: Among the 57 patients enrolled, 37 were males while the other 20 were females. The mean age was 58.53 ± 14.51 years, and a bimodal age distribution at the age of mid-fifties and mid-sixties or older was noted. The later age-peak was related to coexistence of degenerative scoliosis. The average operative time per lamina was 70.34 ± 20.51 minutes and mean length of stay was 0.56 ± 0.85 days. Four perioperative complications were reported (7.0%) and the overall reoperation rate at the index level within 1 year was 8.8%. The preoperative back/leg visual analogue scale scores and functional outcome scales including EuroQol-5 dimension questionnaire, Oswestry Disability Index presented significant improvement immediately after surgery and were maintained until final follow-up. CONCLUSION: ULBRD for bilateral lateral recess stenoses without significant central stenosis resulted in good clinical outcomes with acceptably low perioperative complications rates. Sufficient decompression was achieved with the central ligamentum flavum being preserved. Korean Spinal Neurosurgery Society 2022-12 2022-12-31 /pmc/articles/PMC9816588/ /pubmed/36597639 http://dx.doi.org/10.14245/ns.2244344.172 Text en Copyright © 2022 by the Korean Spinal Neurosurgery Society https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kwon, Woo-Keun Kelly, Katherine A. McAvoy, Malia Sivakanthan, Sananthan Ogunlade, John Yap, Natalie Kai Yi Durfy, Sharon Hofstetter, Christoph P. Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results |
title | Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results |
title_full | Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results |
title_fullStr | Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results |
title_full_unstemmed | Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results |
title_short | Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression: Surgical Technique and Clinical Results |
title_sort | full endoscopic ligamentum flavum sparing unilateral laminotomy for bilateral recess decompression: surgical technique and clinical results |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816588/ https://www.ncbi.nlm.nih.gov/pubmed/36597639 http://dx.doi.org/10.14245/ns.2244344.172 |
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