Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study
Abstract Purpose When it comes to treating lumbar spinal stenosis (LSS), a procedure known as microscope-assisted fenestration decompression has expediently become the gold standard. With the advancement of spinal endoscopy, the Delta large-channel approach has shown promising clinical outcomes in t...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-01-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06143-0 |
| _version_ | 1797946078396416000 |
|---|---|
| author | Yuehang Sheng Jing Li Lei Chen Minghao Geng Jing Fen Shaodong Sun Jianhua Sun |
| author_facet | Yuehang Sheng Jing Li Lei Chen Minghao Geng Jing Fen Shaodong Sun Jianhua Sun |
| author_sort | Yuehang Sheng |
| collection | DOAJ |
| description | Abstract Purpose When it comes to treating lumbar spinal stenosis (LSS), a procedure known as microscope-assisted fenestration decompression has expediently become the gold standard. With the advancement of spinal endoscopy, the Delta large-channel approach has shown promising clinical outcomes in the management of lumbar spinal stenosis. However, case studies of this method being used to treat lumbar spinal stenosis are still uncommon. The purpose of this research was to examine how well microscopy-assisted laminectomy and the Delta large-channel approach work in treating LSS in the clinic. Methods From May 2018 to June 2020, 149 patients diagnosed with LSS were divided into 80 patients in Delta large-channel technique groups (FE group) and 69 patients in microscope groups (Micro group). Lower back and lower limb pain were measured using the visual analogue scale (VAS-LBP and VAS-LP), while lower limb numbness was evaluated using the 11-point numerical rating scale (NRS-LN); modified Oswestry Disability Index (ODI) was used to evaluate the quality of life, and modified MacNab criteria were used to assess the clinical efficacy before surgery and at one week, three months, six months, and 12 months after surgery. All patients had single-level lumbar spinal stenosis, and clinical data such as hospital stay, operation time, intraoperative blood loss were statistically analyzed. Results Finally, 111 patients (62 in FE group and 49 in Micro group) completed follow-up. Compared with preoperative results, postoperative VAS-LBP, VAS-LP, NRS-LN score and modified ODI score were significantly improved in 2 groups (P < 0.05), but there was no significant difference in postoperative follow-up at each time point (P > 0.05), Except 1 week after surgery, VAS-LBP in FE group was lower than that in Micro group (P < 0.05). It is noteworthy that the FE group had a shorter hospital stay, less intraoperative blood loss, and a quicker time of getting out of bed when compared with the microscope group，but the operation time was just the opposite (P < 0.05). The excellent and good rate was 83.87% in FE group and 85.71% in Micro group (P > 0.05). Conclusions Both microscope-assisted laminar fenestration decompression and Delta large-channel procedures provide satisfactory treatment outcomes, however the Delta large-channel approach has some potential advantages for the treatment of LSS, including quicker recovery and sooner reduced VAS-LBP. Long-term consequences, however, will necessitate additional follow-up and research. |
| first_indexed | 2024-04-10T21:05:11Z |
| format | Article |
| id | doaj.art-437db398827549efb8565458586083ca |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-10T21:05:11Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-437db398827549efb8565458586083ca2023-01-22T12:02:13ZengBMCBMC Musculoskeletal Disorders1471-24742023-01-012411910.1186/s12891-023-06143-0Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort studyYuehang Sheng0Jing Li1Lei Chen2Minghao Geng3Jing Fen4Shaodong Sun5Jianhua Sun6Department of Spinal Surgery, The First Affiliated Hospital of Shihezi University School of MedicineDepartment of Spinal Surgery, The First Affiliated Hospital of Shihezi University School of MedicineDepartment of Spinal Surgery, The First Affiliated Hospital of Shihezi University School of MedicineDepartment of Spinal Surgery, The First Affiliated Hospital of Shihezi University School of MedicineDepartment of Spinal Surgery, The First Affiliated Hospital of Shihezi University School of MedicineDepartment of Spinal Surgery, The First Affiliated Hospital of Shihezi University School of MedicineDepartment of Spinal Surgery, The First Affiliated Hospital of Shihezi University School of MedicineAbstract Purpose When it comes to treating lumbar spinal stenosis (LSS), a procedure known as microscope-assisted fenestration decompression has expediently become the gold standard. With the advancement of spinal endoscopy, the Delta large-channel approach has shown promising clinical outcomes in the management of lumbar spinal stenosis. However, case studies of this method being used to treat lumbar spinal stenosis are still uncommon. The purpose of this research was to examine how well microscopy-assisted laminectomy and the Delta large-channel approach work in treating LSS in the clinic. Methods From May 2018 to June 2020, 149 patients diagnosed with LSS were divided into 80 patients in Delta large-channel technique groups (FE group) and 69 patients in microscope groups (Micro group). Lower back and lower limb pain were measured using the visual analogue scale (VAS-LBP and VAS-LP), while lower limb numbness was evaluated using the 11-point numerical rating scale (NRS-LN); modified Oswestry Disability Index (ODI) was used to evaluate the quality of life, and modified MacNab criteria were used to assess the clinical efficacy before surgery and at one week, three months, six months, and 12 months after surgery. All patients had single-level lumbar spinal stenosis, and clinical data such as hospital stay, operation time, intraoperative blood loss were statistically analyzed. Results Finally, 111 patients (62 in FE group and 49 in Micro group) completed follow-up. Compared with preoperative results, postoperative VAS-LBP, VAS-LP, NRS-LN score and modified ODI score were significantly improved in 2 groups (P < 0.05), but there was no significant difference in postoperative follow-up at each time point (P > 0.05), Except 1 week after surgery, VAS-LBP in FE group was lower than that in Micro group (P < 0.05). It is noteworthy that the FE group had a shorter hospital stay, less intraoperative blood loss, and a quicker time of getting out of bed when compared with the microscope group，but the operation time was just the opposite (P < 0.05). The excellent and good rate was 83.87% in FE group and 85.71% in Micro group (P > 0.05). Conclusions Both microscope-assisted laminar fenestration decompression and Delta large-channel procedures provide satisfactory treatment outcomes, however the Delta large-channel approach has some potential advantages for the treatment of LSS, including quicker recovery and sooner reduced VAS-LBP. Long-term consequences, however, will necessitate additional follow-up and research.https://doi.org/10.1186/s12891-023-06143-0Lumbar spinal stenosisSpinal endoscopic techniquesMicroscopyClinical outcomes |
| spellingShingle | Yuehang Sheng Jing Li Lei Chen Minghao Geng Jing Fen Shaodong Sun Jianhua Sun Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study BMC Musculoskeletal Disorders Lumbar spinal stenosis Spinal endoscopic techniques Microscopy Clinical outcomes |
| title | Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study |
| title_full | Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study |
| title_fullStr | Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study |
| title_full_unstemmed | Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study |
| title_short | Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study |
| title_sort | delta large channel technique versus microscopy assisted laminar fenestration decompression for lumbar spinal stenosis a one year prospective cohort study |
| topic | Lumbar spinal stenosis Spinal endoscopic techniques Microscopy Clinical outcomes |
| url | https://doi.org/10.1186/s12891-023-06143-0 |
| work_keys_str_mv | AT yuehangsheng deltalargechanneltechniqueversusmicroscopyassistedlaminarfenestrationdecompressionforlumbarspinalstenosisaoneyearprospectivecohortstudy AT jingli deltalargechanneltechniqueversusmicroscopyassistedlaminarfenestrationdecompressionforlumbarspinalstenosisaoneyearprospectivecohortstudy AT leichen deltalargechanneltechniqueversusmicroscopyassistedlaminarfenestrationdecompressionforlumbarspinalstenosisaoneyearprospectivecohortstudy AT minghaogeng deltalargechanneltechniqueversusmicroscopyassistedlaminarfenestrationdecompressionforlumbarspinalstenosisaoneyearprospectivecohortstudy AT jingfen deltalargechanneltechniqueversusmicroscopyassistedlaminarfenestrationdecompressionforlumbarspinalstenosisaoneyearprospectivecohortstudy AT shaodongsun deltalargechanneltechniqueversusmicroscopyassistedlaminarfenestrationdecompressionforlumbarspinalstenosisaoneyearprospectivecohortstudy AT jianhuasun deltalargechanneltechniqueversusmicroscopyassistedlaminarfenestrationdecompressionforlumbarspinalstenosisaoneyearprospectivecohortstudy |