Clinical Results of Lumbar Foraminal Stenosis in Degenerative Lumbar Scoliosis With Uniportal Endoscopic Decompression
10.21182/jmisst.2024.01900
- Author:
Liu YU-HSIN
;
Chen CHIA-HSIEN
- Publication Type:Original Article
- From:
Journal of Minimally Invasive Spine Surgery and Technique
2025;10(Suppl 2):S210-S217
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:Lumbar foraminal stenosis (FS) is a prevalent cause of radiculopathy, affecting 8%–11% of the population, particularly in individuals with degenerative lumbar scoliosis (DLS). Although minimally invasive techniques such as uniportal endoscopic decompression have emerged, standardized guidelines for FS treatment in DLS patients remain lacking. This study evaluated the clinical outcomes of uniportal endoscopic decompression in treating FS in DLS patients, focusing on lesion location and surgical outcomes.
Methods:This retrospective study included 22 patients with FS and DLS treated between September 2019 and November 2023. Patients were categorized based on whether the lesion was located at the fractional curve or major scoliotic curve. All underwent uniportal endoscopic decompression. Clinical outcomes were assessed using the MacNab criteria over a minimum 12-month follow-up. Predictors of poor outcomes and recurrence, such as the disc wedge angle (DWA) to Cobb angle (CA) ratio, were analyzed using the chi-square test, Mann-Whitney U-test, and the Pearson correlation test.
Results:This study included 22 patients with FS and DLS. The fractional curve group showed better clinical outcomes (81.3% “good” or “excellent”) compared to the major scoliotic curve group (33.4%), although the difference was not statistically significant (p=0.102). However, revision rates were significantly higher in the major scoliotic curve group (66.7% vs. 12.5%, p=0.011). The DWA/CA ratio and fusion timing showed no significant associations within the major scoliotic curve group.
Conclusion:Uniportal endoscopic decompression was effective for FS in the fractional curve, providing sustained symptom relief. However, for FS in the major scoliotic curve, particularly with a high DWA/CA ratio, fusion surgery may be necessary to ensure long-term stability. A comprehensive preoperative evaluation, including the DWA/CA ratio and whole-spine balance assessment, is crucial for optimizing surgical outcomes.
