Lumbar Endoscopic Bony and Soft Tissue Decompression With the Hybridized Inside-Out Approach: A Review And Technical Note
This study aimed to showcase the authors’ preferred technique of a hybrid of modern “inside-out” and “outside-in” endoscopic decompression. A case series of 411 patients consisting of 192 females (46.7%) and 219 males (53.3%) with an average age of 54.84 ± 16.32 years and an average of 43.2 ± 26.53...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2020-07-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-2040160-080.pdf |
| _version_ | 1797329734251577344 |
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| author | Kai-Uwe Lewandrowski Anthony Yeung |
| author_facet | Kai-Uwe Lewandrowski Anthony Yeung |
| author_sort | Kai-Uwe Lewandrowski |
| collection | DOAJ |
| description | This study aimed to showcase the authors’ preferred technique of a hybrid of modern “inside-out” and “outside-in” endoscopic decompression. A case series of 411 patients consisting of 192 females (46.7%) and 219 males (53.3%) with an average age of 54.84 ± 16.32 years and an average of 43.2 ± 26.53 months are presented. Patients underwent surgery for low-grade spondylolisthesis (13 of 411, 3.2%), herniated disc (135 of 411, 32.8%), foraminal spinal stenosis (101 of 411, 24.6%), or a combination of the latter 2 conditions (162 of 411, 39.4%). The preoperative Oswestry Disability Index (ODI) and visual analogue scale (VAS) for leg pain were 49.8 ± 17.65 and 7.9 ± 1.55, respectively. Postoperative ODI and VAS leg were 12.2 ± 9.34 and 2.41 ± 5 1.55 at final follow-up (p < 0.0001). MacNab outcomes were excellent in 134 (32.6%), good in 228 (55.5%), fair in 40 (9.7%), and poor in 9 patients (2.2%), respectively. There was end-stage degenerative vacuum disc disease in 304 of the 411 patients (74%) of which had 37.5% had excellent and 50% good MacNab outcomes. Patients without vacuum discs had excellent and good 18.7% and 71.0% of the time. Direct visualization of pain generators in the epidural- and intradiscal space is the authors’ preferred transforaminal decompression technique and is supported by their reliable clinical outcomes. |
| first_indexed | 2024-03-08T07:09:45Z |
| format | Article |
| id | doaj.art-80d3525bfdc547a0a74a0c08a6616764 |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T07:09:45Z |
| publishDate | 2020-07-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-80d3525bfdc547a0a74a0c08a66167642024-02-03T03:29:06ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912020-07-0117Suppl 1S34S4310.14245/ns.2040160.0801029Lumbar Endoscopic Bony and Soft Tissue Decompression With the Hybridized Inside-Out Approach: A Review And Technical NoteKai-Uwe Lewandrowski0Anthony Yeung1 Center for Advanced Spine Care of Southern Arizona, Surgical Institute of Tucson, Tucson, AZ, USA Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM, USAThis study aimed to showcase the authors’ preferred technique of a hybrid of modern “inside-out” and “outside-in” endoscopic decompression. A case series of 411 patients consisting of 192 females (46.7%) and 219 males (53.3%) with an average age of 54.84 ± 16.32 years and an average of 43.2 ± 26.53 months are presented. Patients underwent surgery for low-grade spondylolisthesis (13 of 411, 3.2%), herniated disc (135 of 411, 32.8%), foraminal spinal stenosis (101 of 411, 24.6%), or a combination of the latter 2 conditions (162 of 411, 39.4%). The preoperative Oswestry Disability Index (ODI) and visual analogue scale (VAS) for leg pain were 49.8 ± 17.65 and 7.9 ± 1.55, respectively. Postoperative ODI and VAS leg were 12.2 ± 9.34 and 2.41 ± 5 1.55 at final follow-up (p < 0.0001). MacNab outcomes were excellent in 134 (32.6%), good in 228 (55.5%), fair in 40 (9.7%), and poor in 9 patients (2.2%), respectively. There was end-stage degenerative vacuum disc disease in 304 of the 411 patients (74%) of which had 37.5% had excellent and 50% good MacNab outcomes. Patients without vacuum discs had excellent and good 18.7% and 71.0% of the time. Direct visualization of pain generators in the epidural- and intradiscal space is the authors’ preferred transforaminal decompression technique and is supported by their reliable clinical outcomes.http://www.e-neurospine.org/upload/pdf/ns-2040160-080.pdfendoscopyherniated discspinal stenosis |
| spellingShingle | Kai-Uwe Lewandrowski Anthony Yeung Lumbar Endoscopic Bony and Soft Tissue Decompression With the Hybridized Inside-Out Approach: A Review And Technical Note Neurospine endoscopy herniated disc spinal stenosis |
| title | Lumbar Endoscopic Bony and Soft Tissue Decompression With the Hybridized Inside-Out Approach: A Review And Technical Note |
| title_full | Lumbar Endoscopic Bony and Soft Tissue Decompression With the Hybridized Inside-Out Approach: A Review And Technical Note |
| title_fullStr | Lumbar Endoscopic Bony and Soft Tissue Decompression With the Hybridized Inside-Out Approach: A Review And Technical Note |
| title_full_unstemmed | Lumbar Endoscopic Bony and Soft Tissue Decompression With the Hybridized Inside-Out Approach: A Review And Technical Note |
| title_short | Lumbar Endoscopic Bony and Soft Tissue Decompression With the Hybridized Inside-Out Approach: A Review And Technical Note |
| title_sort | lumbar endoscopic bony and soft tissue decompression with the hybridized inside out approach a review and technical note |
| topic | endoscopy herniated disc spinal stenosis |
| url | http://www.e-neurospine.org/upload/pdf/ns-2040160-080.pdf |
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