Eccentric reaming technique in percutaneous endoscopic lumbar discectomy in the treatment of lumbar lateral recess stenosis: a five-year case series study
10.3760/cma.j.issn.0253-2352.2018.16.005
- VernacularTitle:偏心环锯技术在经皮内镜治疗腰椎侧隐窝狭窄症中的临床应用
- Author:
Haiyin LI
1
;
Xuesong MU
;
Weiren LAN
;
Changqing JIANG
;
Chao ZHANG
;
Wenjie ZHENG
;
Yue ZHOU
;
Changqing LI
Author Information
1. 陆军军医大学附属新桥医院骨科
- Keywords:
Lumbar vertebrae;
Spinal stenosis;
Endoscopy;
Surgical procedures,minimally invasive
- From:
Chinese Journal of Orthopaedics
2018;38(16):996-1002
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate clinical effect and safety of eccentric reamer technique foraminoplasty during percutaneous endoscopic lumbar discectomy for the treatment of lumbar lateral recess stenosis.Methods All of 45 cases diagnosed of lumbar lateral recess stenosis between Apr 2010 to Jun 2012 were analyzed in our study.Among these cases,28 cases were male and 17 were female.The age of enrolled cases was 39-62 years old and the average age was 49.23±23.96 years old.All the cases were one-level,25 cases in L4,5 and 20 cases in L5S1.All the patients underwent percutaneous endoscopic lumbar discectomy.During surgery,eccentric reamer technique was applied for foraminoplasty.Perioperative data included surgical segment,surgical duration and blood loss during surgery.Oswestry Disability Index (ODI) and Visual analogue scale (VAS) for lower back and leg pain were recorded for the evaluation of surgical effect.All the data were recorded before surgery,1 day,1 month after surgery and final follow-up.Recurrent lumbar disc herniation,spinal canal hematoma,intervertebral disc infection,nerve root injury and post-operative dysthesia (POD) were recorded for complications.Results All the cases finished surgery and none of the cases was changed to other surgery method and no other electronic drill were used in these patients.Surgical duration was 45-76 min and average time was 61.23± 13.89 min.Blood loss during surgery was 10-25 ml and average blood loss was 15.02±4.33 ml.Post-operative hospitalization days were 1-3 days and 2.80±1.57 days.The follow-up time was 60-84 months and the average time was 73.23±8.47 months.ODI in one-day after surgery was 9.34±6.54％,significantly lower than 68.06±24.14％ before surgery and no statistically change had been observed in one-month after surgery and final follow-up.The VAS for lower back was 1.54±0.97 in one-day after surgery,significantly lower than 3.57±3.12 before surgery.The VAS for leg pain was 1.14±0.79 in one-day after surgery,significantly lower than 6.24±2.35 before surgery.During follow-up,1 case suffered from recurrent lumbar disc herniation (2.22％) and no intervertebral disc infection,spinal canal hematoma and POD was observed.Conclusion Eccentric reamer technique foraminoplasty in percutaneous endoscopic lumbar discectomy is an effective and safe surgical method for the treatment of lumbar lateral recess stenosis.
