Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal Lesions
Study DesignRetrospective study.PurposeThis study aimed to evaluate the efficacy of minimally invasive transtubular endoscopic decompression for the treatment of lumbosacral extraforaminal lesion (LSEFL).Overview of LiteratureConventional procedures for surgical decompression for the treatment of LS...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2018-04-01
|
| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-12-246.pdf |
| _version_ | 1818016365204733952 |
|---|---|
| author | Ko Ikuta Takahiro Kitamura Keigo Masuda Kensuke Hotta Hideyuki Senba Satoshi Shidahara |
| author_facet | Ko Ikuta Takahiro Kitamura Keigo Masuda Kensuke Hotta Hideyuki Senba Satoshi Shidahara |
| author_sort | Ko Ikuta |
| collection | DOAJ |
| description | Study DesignRetrospective study.PurposeThis study aimed to evaluate the efficacy of minimally invasive transtubular endoscopic decompression for the treatment of lumbosacral extraforaminal lesion (LSEFL).Overview of LiteratureConventional procedures for surgical decompression for the treatment of LSEFL involve certain technical challenges because the lumbosacral extraforaminal region has unique anatomical features. Moreover, the efficacy of minimally invasive procedures performed via the posterolateral approach for LSEFL has been reported.MethodsTwenty-five patients who had undergone minimally invasive transtubular endoscopic decompression for the treatment of LSEFL and could be followed up for at least 1 year postoperatively were enrolled. Five of these patients had a history of lumbar surgery, and seven had concomitant adjacent-level spinal stenosis. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) lumbar score, numeric rating scale (NRS), and the JOA Back Pain Evaluation Questionnaire (JOABPEQ). The mean postoperative follow-up (FU) duration was 3.8 years.ResultsAll procedures could be completed without any severe surgical complications, and all patients could resume their previous activity level within 1 month postoperatively. The JOA score significantly increased from 14.1±4.0 at baseline to 23.1±3.7 at the 1-year FU and 22.1±3.8 at the last FU. Similarly, there were significant improvements in the postoperative NRS and JOABPEQ scores. An additional surgery was performed in two patients (8%) during the FU period. Patients with degenerative scoliosis exhibited significantly poorer outcomes compared with those without this condition.ConclusionsTranstubular endoscopic decompression can overcome certain technical challenges involved in the conventional procedures for LSEFL treatment; therefore, it can be recommended as a useful procedure for treating LSEFL. This procedure can provide some benefits to LSEFL patients and offer a well-illuminated surgical field and high surgical safety for the surgeon. However, the procedure should be carefully adapted for LSEFL patients with concomitant degenerative scoliosis. |
| first_indexed | 2024-04-14T07:12:23Z |
| format | Article |
| id | doaj.art-3c42c6582027473bb510327f403f9331 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-14T07:12:23Z |
| publishDate | 2018-04-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-3c42c6582027473bb510327f403f93312022-12-22T02:06:24ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462018-04-0112224625510.4184/asj.2018.12.2.246342Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal LesionsKo Ikuta0Takahiro Kitamura1Keigo Masuda2Kensuke Hotta3Hideyuki Senba4Satoshi Shidahara5Department of Orthopedic Surgery, Karatsu Red Cross Hospital, Karatsu, Japan.Department of Orthopedic Surgery, Karatsu Red Cross Hospital, Karatsu, Japan.Department of Orthopedic Surgery, Karatsu Red Cross Hospital, Karatsu, Japan.Department of Orthopedic Surgery, Karatsu Red Cross Hospital, Karatsu, Japan.Department of Orthopedic Surgery, Karatsu Red Cross Hospital, Karatsu, Japan.Department of Orthopedic Surgery, Karatsu Red Cross Hospital, Karatsu, Japan.Study DesignRetrospective study.PurposeThis study aimed to evaluate the efficacy of minimally invasive transtubular endoscopic decompression for the treatment of lumbosacral extraforaminal lesion (LSEFL).Overview of LiteratureConventional procedures for surgical decompression for the treatment of LSEFL involve certain technical challenges because the lumbosacral extraforaminal region has unique anatomical features. Moreover, the efficacy of minimally invasive procedures performed via the posterolateral approach for LSEFL has been reported.MethodsTwenty-five patients who had undergone minimally invasive transtubular endoscopic decompression for the treatment of LSEFL and could be followed up for at least 1 year postoperatively were enrolled. Five of these patients had a history of lumbar surgery, and seven had concomitant adjacent-level spinal stenosis. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) lumbar score, numeric rating scale (NRS), and the JOA Back Pain Evaluation Questionnaire (JOABPEQ). The mean postoperative follow-up (FU) duration was 3.8 years.ResultsAll procedures could be completed without any severe surgical complications, and all patients could resume their previous activity level within 1 month postoperatively. The JOA score significantly increased from 14.1±4.0 at baseline to 23.1±3.7 at the 1-year FU and 22.1±3.8 at the last FU. Similarly, there were significant improvements in the postoperative NRS and JOABPEQ scores. An additional surgery was performed in two patients (8%) during the FU period. Patients with degenerative scoliosis exhibited significantly poorer outcomes compared with those without this condition.ConclusionsTranstubular endoscopic decompression can overcome certain technical challenges involved in the conventional procedures for LSEFL treatment; therefore, it can be recommended as a useful procedure for treating LSEFL. This procedure can provide some benefits to LSEFL patients and offer a well-illuminated surgical field and high surgical safety for the surgeon. However, the procedure should be carefully adapted for LSEFL patients with concomitant degenerative scoliosis.http://www.asianspinejournal.org/upload/pdf/asj-12-246.pdfLumbosacral radiculopathyExtraforaminal lumbar disc herniationExtraforaminal stenosisMinimally invasive spine surgery |
| spellingShingle | Ko Ikuta Takahiro Kitamura Keigo Masuda Kensuke Hotta Hideyuki Senba Satoshi Shidahara Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal Lesions Asian Spine Journal Lumbosacral radiculopathy Extraforaminal lumbar disc herniation Extraforaminal stenosis Minimally invasive spine surgery |
| title | Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal Lesions |
| title_full | Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal Lesions |
| title_fullStr | Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal Lesions |
| title_full_unstemmed | Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal Lesions |
| title_short | Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal Lesions |
| title_sort | minimally invasive transtubular endoscopic decompression for l5 radiculopathy induced by lumbosacral extraforaminal lesions |
| topic | Lumbosacral radiculopathy Extraforaminal lumbar disc herniation Extraforaminal stenosis Minimally invasive spine surgery |
| url | http://www.asianspinejournal.org/upload/pdf/asj-12-246.pdf |
| work_keys_str_mv | AT koikuta minimallyinvasivetranstubularendoscopicdecompressionforl5radiculopathyinducedbylumbosacralextraforaminallesions AT takahirokitamura minimallyinvasivetranstubularendoscopicdecompressionforl5radiculopathyinducedbylumbosacralextraforaminallesions AT keigomasuda minimallyinvasivetranstubularendoscopicdecompressionforl5radiculopathyinducedbylumbosacralextraforaminallesions AT kensukehotta minimallyinvasivetranstubularendoscopicdecompressionforl5radiculopathyinducedbylumbosacralextraforaminallesions AT hideyukisenba minimallyinvasivetranstubularendoscopicdecompressionforl5radiculopathyinducedbylumbosacralextraforaminallesions AT satoshishidahara minimallyinvasivetranstubularendoscopicdecompressionforl5radiculopathyinducedbylumbosacralextraforaminallesions |