Full-Endoscopic Decompression for Lumbar Lateral Recess Stenosis via an Interlaminar Approach versus a Transforaminal Approach

Abstract

Objective: To compare the results of full-endoscopic decompression (FED) in lumbar lateral recess stenosis via an interlaminar or transforaminal approach.

Methods: A total of 102 patients with lumbar lateral recess stenosis who underwent FED from February 2015 to June 2016 in our hospital were enrolled. A total of 58 patients underwent interlaminar FED (IL-FED) and 44 patients underwent transforaminal FED (TF-FED). The intraoperative radiation and operation time, length of hospital stay, time to return to work, and complications were compared between both groups. The surgical effectiveness was assessed according to the visual analog scale, Oswestry Disability Index, and modified MacNab criteria.

Results: In the IL-FED group, the mean operation time was 59.4 ± 8.5 minutes, and the intraoperative radiation time was 0.50 ± 0.16 seconds. In the TF-FED group, the mean operation time was 64.1 ± 10.2 minutes, and the intraoperative radiation time was 7.50 ± 1.25 seconds. There were significant differences in the operation and radiation time between the 2 groups (P < 0.01). There was no significant difference in the visual analog scale and Oswestry Disability Index scoring between both groups either in the pre- or postoperation (P > 0.05). Based on the modified MacNab scores at the final follow-up, the satisfactory rate in the IL-FED group was 91.4% and that in the TF-FED group was 88.6%, no significant difference was observed between the 2 groups (P > 0.05).

Conclusions: FED could provide satisfactory clinical outcomes for lumbar lateral recess stenosis. However, the IL-FED procedure demonstrated shorter operation time and lesser radiation exposure, but higher risk for anesthetic when compared with the TF-FED procedure.

Keywords: Full-endoscopic; Interlaminar decompression; Lateral recess stenosis; Transforaminal decompression.