Clinical Results of 10-mm Endoscopic Minimally Invasive Interlaminar Decompression in the Treatment of Lumbar Spinal Stenosis with Degenerative Lumbar Scoliosis and Simple Lumbar Spinal Stenosis

Purpose The number of patients with lumbar spinal stenosis (LSS) with degenerative lumbar scoliosis (DLS) is gradually increasing as the population ages. The purpose of this study was to evaluate the clinical outcomes of 10-mm endoscopic minimally invasive interlaminar decompression for LSS with DLS and simple LSS. Material and Methods The clinical data of 175 consecutive elderly patients with LSS were retrospectively analyzed. They were divided into LSS group and LSS with DLS group based on whether they were accompanied by DLS. Patient demographics, perioperative indicators, and clinical outcomes were recorded. Lumbar spine stability was assessed by imaging data. Meanwhile, visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and the modified Macnab criteria were used to assess clinical outcomes. Results There were 129 patients in the LSS group and 46 patients in the LSS with DLS group. Both groups had similar VAS and ODI scores preoperatively, and both were significantly lower postoperatively (P < 0.05). However, patients combined with DLS showed higher VAS scores for low back pain at 3 months and 1 year postoperatively (P < 0.05). In addition, postoperative LL and PI-LL were significantly improved in both groups (P < 0.05). However, patients in LSS with DLS group showed higher PT, PI and PI-LL before and after surgery. According to the modified Macnab criteria, the excellent and good rates were 92.25% and 89.13% in the LSS group and LSS with DLS group at the last follow-up, respectively. Conclusion 10-mm endoscopic minimally invasive interlaminar decompression for LSS with or without DLS has shown satisfactory clinical outcomes. However, patients with DLS may have higher residual low back pain after surgery.

[1]  G. Shi,et al.  The clinical effectiveness and complications of lumbar selective fenestration and concave-side fusion (LSFCF) in degenerative lumbar scoliosis (DLS) combined with lumbar spinal stenosis (LSS) , 2022, BMC Surgery.

[2]  Weishi Li,et al.  Motion of Lumbar Endplate in Degenerative Lumbar Scoliosis Patients with Different Cobb Angle In Vivo: Reflecting the Biomechanics of the Lumbar Disc , 2022, BioMed research international.

[3]  Samuel K. Cho,et al.  Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis , 2022, Global spine journal.

[4]  J. Katz,et al.  Diagnosis and Management of Lumbar Spinal Stenosis: A Review. , 2022, JAMA.

[5]  Y. Qiu,et al.  The role of paraspinal muscle degeneration in coronal imbalance in patients with degenerative scoliosis , 2022, Quantitative imaging in medicine and surgery.

[6]  Ning Fan,et al.  Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis , 2021, BMC Musculoskeletal Disorders.

[7]  H. Takashima,et al.  Factors associated with low back pain in patients with lumbar spinal stenosis: a cross-sectional study , 2021, BMC Musculoskeletal Disorders.

[8]  Michael J. Schneider,et al.  Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical practice guideline. , 2021, The journal of pain.

[9]  K. Ha,et al.  Decompressive Laminectomy Alone for Degenerative Lumbar Scoliosis with Spinal Stenosis: Incidence of Post-Laminectomy Instability in the Elderly , 2020, Clinics in orthopedic surgery.

[10]  Kai Xu,et al.  Clinical Comparison of Full-Endoscopic and Microscopic Unilateral Laminotomy for Bilateral Decompression in the Treatment of Elderly Lumbar Spinal stenosis: A Retrospective Study with 12-Month Follow-Up , 2020, Journal of pain research.

[11]  M. Farshad,et al.  Biomechanical contribution of spinal structures to stability of the lumbar spine - Novel biomechanical insights. , 2020, The spine journal : official journal of the North American Spine Society.

[12]  Benjamin T. Brown,et al.  The prevalence of adult de novo scoliosis: A systematic review and meta-analysis , 2020, European Spine Journal.

[13]  Z. Wang,et al.  Limited correction of lumbar lordosis in the treatment of degenerative scoliosis , 2020, Medicine.

[14]  Timothy R. Smith,et al.  Minimally invasive versus open surgery for the correction of adult degenerative scoliosis: a systematic review , 2020, Neurosurgical Review.

[15]  Zhongjun Liu,et al.  Association Between Radiographic Spinopelvic Parameters and Health-related Quality of Life in De Novo Degenerative Lumbar Scoliosis and Concomitant Lumbar Spinal Stenosis , 2020, Spine.

[16]  S. Ruetten,et al.  Endoscopic Lumbar Decompression. , 2020, Neurosurgery clinics of North America.

[17]  Nishant Kumar,et al.  Analysis of the Functional and Radiological Outcomes of Lumbar Decompression without Fusion in Patients with Degenerative Lumbar Scoliosis , 2019, Asian spine journal.

[18]  Michael J. Schneider,et al.  Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis , 2019, JAMA network open.

[19]  H. Yoshihara,et al.  Relationship between sagittal radiographic parameters and disability in patients with spinal disease using 3D standing analysis. , 2018, Orthopaedics & traumatology, surgery & research : OTSR.

[20]  Tomoyuki Saito,et al.  The surgical outcome of decompression alone versus decompression with limited fusion for degenerative lumbar scoliosis. , 2018, Journal of neurosurgery. Spine.

[21]  A. Minamide,et al.  Minimally invasive decompression surgery for lumbar spinal stenosis with degenerative scoliosis: Predictive factors of radiographic and clinical outcomes. , 2017, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[22]  N. Kawamura,et al.  Radiological Improvements in Global Sagittal Alignment After Lumbar Decompression Without Fusion , 2015, Spine.

[23]  Yitao Ding,et al.  Coronal Curvature and Spinal Imbalance in Degenerative Lumbar Scoliosis: Disc Degeneration Is Associated , 2014, Spine.

[24]  T. Jahng,et al.  Decompression and nonfusion dynamic stabilization for spinal stenosis with degenerative lumbar scoliosis: Clinical article. , 2014, Journal of neurosurgery. Spine.

[25]  Oheneba Boachie-Adjei,et al.  Radiographical Spinopelvic Parameters and Disability in the Setting of Adult Spinal Deformity: A Prospective Multicenter Analysis , 2013, Spine.

[26]  W. Lauerman,et al.  Adult Spinal Deformity , 2016 .

[27]  C. Ames,et al.  Morbidity and mortality after spinal deformity surgery in patients 75 years and older: complications and predictive factors. , 2011, Journal of neurosurgery. Spine.

[28]  L. Lenke,et al.  Adult degenerative scoliosis: evaluation and management. , 2010, Neurosurgical focus.

[29]  R. Winter,et al.  Surgical Outcomes of Decompression, Decompression With Limited Fusion, and Decompression With Full Curve Fusion for Degenerative Scoliosis With Radiculopathy , 2008, Spine.

[30]  A. Ploumis,et al.  Degenerative lumbar scoliosis associated with spinal stenosis. , 2007, The spine journal : official journal of the North American Spine Society.

[31]  M. Takemitsu,et al.  A Prospective Study of De Novo Scoliosis in a Community Based Cohort , 2006, Spine.

[32]  M. Aebi The adult scoliosis , 2005, European Spine Journal.

[33]  H. Chang Influence of Lumbar Lordosis on the Outcome of Decompression Surgery for Lumbar Canal Stenosis. , 2018, World neurosurgery.