The Novel Technique of Uniportal Endoscopic Interlaminar Contralateral Approach for Coexisting L5-S1 Lateral Recess, Foraminal, and Extraforaminal Stenosis and Its Clinical Outcomes
Background: Multifocal intra-and-extraspinal lumbar stenotic lesions could be decompressed with one endoscopic surgical approach, which has the advantages of functional structure preservation, technical efficacy, and safety. Methods: A retrospective study was performed on 48 patients who underwent u...
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MDPI AG
2021-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/7/1364 |
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| author | Ji Yeon Kim Hyeun Sung Kim Jun Bok Jeon Jun Hyung Lee Jun Hwan Park Il-Tae Jang |
| author_facet | Ji Yeon Kim Hyeun Sung Kim Jun Bok Jeon Jun Hyung Lee Jun Hwan Park Il-Tae Jang |
| author_sort | Ji Yeon Kim |
| collection | DOAJ |
| description | Background: Multifocal intra-and-extraspinal lumbar stenotic lesions could be decompressed with one endoscopic surgical approach, which has the advantages of functional structure preservation, technical efficacy, and safety. Methods: A retrospective study was performed on 48 patients who underwent uniportal endoscopic contralateral approach due to coexisting lateral recess, foraminal, and extraforaminal stenosis at the L5-S1 level. Foraminal stenosis grade and postoperative dysesthesia (POD) were analyzed. Visual analog scale (VAS) pain scores, modified Oswestry Disability Index (ODI) scores, and MacNab criteria for evaluating pain disability and response were analyzed. Results: The foraminal stenosis grade of the treated spinal levels was grade 1 (<i>n</i> = 16, 33%), grade 2 (<i>n</i> = 20, 42%), and grade 3 (<i>n</i> = 12, 25%). The rate of occurrence of POD grade 2 and above, which may be related to intraoperative dorsal root ganglion (DRG) retraction injury, was revealed to be 4.2% (two with grade 2, none with grade 3). The patients showed favorable clinical outcomes. Conclusions: Uniportal endoscopic interlaminar contralateral approach is an effective procedure to resolve combined stenosis (lateral recess, foraminal, and extraforaminal region) with one surgical approach at the L5-S1 level. It may be a minimal DRG retracting and facet joint preserving procedure in foraminal and extraforaminal decompression. |
| first_indexed | 2024-03-10T12:52:16Z |
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| language | English |
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| spelling | doaj.art-6c679d164ef74a66aaefe9213bad35362023-11-21T12:10:02ZengMDPI AGJournal of Clinical Medicine2077-03832021-03-01107136410.3390/jcm10071364The Novel Technique of Uniportal Endoscopic Interlaminar Contralateral Approach for Coexisting L5-S1 Lateral Recess, Foraminal, and Extraforaminal Stenosis and Its Clinical OutcomesJi Yeon Kim0Hyeun Sung Kim1Jun Bok Jeon2Jun Hyung Lee3Jun Hwan Park4Il-Tae Jang5Department of Neurosurgery, Spine Center, Leon Wiltse Memorial Hospital, Anyang 14112, KoreaDepartment of Neurosurgery, Spine Center, Nanoori Gangnam Hospital, Seoul 06048, KoreaDepartment of Neurosurgery, Spine Center, Nanoori Gangnam Hospital, Seoul 06048, KoreaDepartment of Internal Medicine, Chosun University School of Medicine, Gwangju 61453, KoreaThe Faculty of Medicine of the University of Debrecen, Nagyerdei krt. 94, 4032 Debrecen, HungaryDepartment of Neurosurgery, Spine Center, Nanoori Gangnam Hospital, Seoul 06048, KoreaBackground: Multifocal intra-and-extraspinal lumbar stenotic lesions could be decompressed with one endoscopic surgical approach, which has the advantages of functional structure preservation, technical efficacy, and safety. Methods: A retrospective study was performed on 48 patients who underwent uniportal endoscopic contralateral approach due to coexisting lateral recess, foraminal, and extraforaminal stenosis at the L5-S1 level. Foraminal stenosis grade and postoperative dysesthesia (POD) were analyzed. Visual analog scale (VAS) pain scores, modified Oswestry Disability Index (ODI) scores, and MacNab criteria for evaluating pain disability and response were analyzed. Results: The foraminal stenosis grade of the treated spinal levels was grade 1 (<i>n</i> = 16, 33%), grade 2 (<i>n</i> = 20, 42%), and grade 3 (<i>n</i> = 12, 25%). The rate of occurrence of POD grade 2 and above, which may be related to intraoperative dorsal root ganglion (DRG) retraction injury, was revealed to be 4.2% (two with grade 2, none with grade 3). The patients showed favorable clinical outcomes. Conclusions: Uniportal endoscopic interlaminar contralateral approach is an effective procedure to resolve combined stenosis (lateral recess, foraminal, and extraforaminal region) with one surgical approach at the L5-S1 level. It may be a minimal DRG retracting and facet joint preserving procedure in foraminal and extraforaminal decompression.https://www.mdpi.com/2077-0383/10/7/1364endoscopylumbarcontralateralforaminotomystenosisdysesthesia |
| spellingShingle | Ji Yeon Kim Hyeun Sung Kim Jun Bok Jeon Jun Hyung Lee Jun Hwan Park Il-Tae Jang The Novel Technique of Uniportal Endoscopic Interlaminar Contralateral Approach for Coexisting L5-S1 Lateral Recess, Foraminal, and Extraforaminal Stenosis and Its Clinical Outcomes Journal of Clinical Medicine endoscopy lumbar contralateral foraminotomy stenosis dysesthesia |
| title | The Novel Technique of Uniportal Endoscopic Interlaminar Contralateral Approach for Coexisting L5-S1 Lateral Recess, Foraminal, and Extraforaminal Stenosis and Its Clinical Outcomes |
| title_full | The Novel Technique of Uniportal Endoscopic Interlaminar Contralateral Approach for Coexisting L5-S1 Lateral Recess, Foraminal, and Extraforaminal Stenosis and Its Clinical Outcomes |
| title_fullStr | The Novel Technique of Uniportal Endoscopic Interlaminar Contralateral Approach for Coexisting L5-S1 Lateral Recess, Foraminal, and Extraforaminal Stenosis and Its Clinical Outcomes |
| title_full_unstemmed | The Novel Technique of Uniportal Endoscopic Interlaminar Contralateral Approach for Coexisting L5-S1 Lateral Recess, Foraminal, and Extraforaminal Stenosis and Its Clinical Outcomes |
| title_short | The Novel Technique of Uniportal Endoscopic Interlaminar Contralateral Approach for Coexisting L5-S1 Lateral Recess, Foraminal, and Extraforaminal Stenosis and Its Clinical Outcomes |
| title_sort | novel technique of uniportal endoscopic interlaminar contralateral approach for coexisting l5 s1 lateral recess foraminal and extraforaminal stenosis and its clinical outcomes |
| topic | endoscopy lumbar contralateral foraminotomy stenosis dysesthesia |
| url | https://www.mdpi.com/2077-0383/10/7/1364 |
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