TY - JOUR
T1 - Full Endoscopic Ligamentum Flavum Sparing Unilateral Laminotomy for Bilateral Recess Decompression
T2 - Surgical Technique and Clinical Results
AU - Kwon, Woo Keun
AU - Kelly, Katherine A.
AU - McAvoy, Malia
AU - Sivakanthan, Sananthan
AU - Ogunlade, John
AU - Yap, Natalie Kai Yi
AU - Durfy, Sharon
AU - Hofstetter, Christoph P.
N1 - Publisher Copyright:
© 2022 by the Korean Spinal Neurosurgery Society.
PY - 2022/12
Y1 - 2022/12
N2 - 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 retro-spectively. One hundred eighty-two consecutive cases from a single center between Sep-tember 2015 and March 2021 were reviewed and 57 of them whom underwent ULBRD were enrolled for analysis. Basic patient demographic data, perioperative details, surgery-related 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-fif-ties 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 Eu-roQol-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.
AB - 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 retro-spectively. One hundred eighty-two consecutive cases from a single center between Sep-tember 2015 and March 2021 were reviewed and 57 of them whom underwent ULBRD were enrolled for analysis. Basic patient demographic data, perioperative details, surgery-related 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-fif-ties 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 Eu-roQol-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.
KW - Endoscopic spine surgery
KW - Interlaminar endoscopic lateral recess decompress
KW - Lateral recess stenosis
KW - Minimally invasive spine surgery
KW - Radiculopathy
UR - http://www.scopus.com/inward/record.url?scp=85145197297&partnerID=8YFLogxK
U2 - 10.14245/ns.2244344.172
DO - 10.14245/ns.2244344.172
M3 - Article
C2 - 36597639
AN - SCOPUS:85145197297
SN - 2586-6583
VL - 19
SP - 1028
EP - 1038
JO - Neurospine
JF - Neurospine
IS - 4
ER -