Comparative Cohort Study for Expansion of Lateral Recess and Facet Joint Injury after Biportal Endoscopic Ipsilateral Decompression and Contralateral Decompression
Study Design This was a retrospective longitudinal study of patients operated on consecutively in a single center from May to October 2019. Purpose The aim in biportal interlaminar endoscopic decompression surgery for lumbar stenosis is to compare the clinical and radiological outcome of lateral rec...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2022-08-01
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| Series: | Asian Spine Journal |
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| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2020-0656.pdf |
| _version_ | 1798032249135824896 |
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| author | Yip-kan Yeung Cheol-woong Park Su Gi Jun Jung-hoon Park Andy Choi-yeung Tse |
| author_facet | Yip-kan Yeung Cheol-woong Park Su Gi Jun Jung-hoon Park Andy Choi-yeung Tse |
| author_sort | Yip-kan Yeung |
| collection | DOAJ |
| description | Study Design This was a retrospective longitudinal study of patients operated on consecutively in a single center from May to October 2019. Purpose The aim in biportal interlaminar endoscopic decompression surgery for lumbar stenosis is to compare the clinical and radiological outcome of lateral recess decompression and facet preservation, employing ipsilateral (IL) versus contralateral (CL) approaches. Overview of Literature There is scant literature comparing the radiological outcome of lateral recess decompression and facet preservation via IL versus CL approaches in patients undergoing biportal interlaminar endoscopic decompression surgery. Methods In this retrospective study, we reviewed 37 IL and 34 CL approaches. Postoperative magnetic resonance imaging of the segment involved was carried out on the same day as the operation for comparison with preoperative imaging. Radiological assessments of recess angle, recess height, facet length, and recess dural sac diameters were compared. In addition, pre- and postoperative Visual Analog Scale (VAS) pain scores for the lower limb were analyzed. Results For IL versus CL approaches, we observed statistical differences in the postoperative recess angle (36.0° vs. 43.7°), recess height (4.27 vs. 5.06 mm), and the dural sac expansion ratio for recess diameter (1.54 vs. 2.17). There was better preservation of facet length in the CL approach than in the IL approach (91.9% vs. 83.7%). There was no difference in VAS improvement between the groups (69.3% vs. 63.6%). Conclusions Unilateral biportal decompression via the CL interlaminar approach may offer better lateral recess clearance and facet preservation than can be achieved via the IL approach. Larger-scale studies are needed for better delineation and for correlation of radiological features with clinical manifestations. |
| first_indexed | 2024-04-11T20:10:59Z |
| format | Article |
| id | doaj.art-e73124a4a618459e9a2e1d69411d06c3 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-11T20:10:59Z |
| publishDate | 2022-08-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-e73124a4a618459e9a2e1d69411d06c32022-12-22T04:05:06ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462022-08-0116456056610.31616/asj.2020.06561395Comparative Cohort Study for Expansion of Lateral Recess and Facet Joint Injury after Biportal Endoscopic Ipsilateral Decompression and Contralateral DecompressionYip-kan Yeung0Cheol-woong Park1Su Gi Jun2Jung-hoon Park3Andy Choi-yeung Tse4 Department of Orthopaedics and Traumatology, Caritas Medical Centre, Hong Kong Department of Spinal Surgery, Daejeon Woori Hospital, Daejeon, Korea Department of Spinal Surgery, Daejeon Woori Hospital, Daejeon, Korea Department of Spinal Surgery, Daejeon Woori Hospital, Daejeon, Korea Department of Health and Physical Education, The Education University of Hong Kong, Hong KongStudy Design This was a retrospective longitudinal study of patients operated on consecutively in a single center from May to October 2019. Purpose The aim in biportal interlaminar endoscopic decompression surgery for lumbar stenosis is to compare the clinical and radiological outcome of lateral recess decompression and facet preservation, employing ipsilateral (IL) versus contralateral (CL) approaches. Overview of Literature There is scant literature comparing the radiological outcome of lateral recess decompression and facet preservation via IL versus CL approaches in patients undergoing biportal interlaminar endoscopic decompression surgery. Methods In this retrospective study, we reviewed 37 IL and 34 CL approaches. Postoperative magnetic resonance imaging of the segment involved was carried out on the same day as the operation for comparison with preoperative imaging. Radiological assessments of recess angle, recess height, facet length, and recess dural sac diameters were compared. In addition, pre- and postoperative Visual Analog Scale (VAS) pain scores for the lower limb were analyzed. Results For IL versus CL approaches, we observed statistical differences in the postoperative recess angle (36.0° vs. 43.7°), recess height (4.27 vs. 5.06 mm), and the dural sac expansion ratio for recess diameter (1.54 vs. 2.17). There was better preservation of facet length in the CL approach than in the IL approach (91.9% vs. 83.7%). There was no difference in VAS improvement between the groups (69.3% vs. 63.6%). Conclusions Unilateral biportal decompression via the CL interlaminar approach may offer better lateral recess clearance and facet preservation than can be achieved via the IL approach. Larger-scale studies are needed for better delineation and for correlation of radiological features with clinical manifestations.http://www.asianspinejournal.org/upload/pdf/asj-2020-0656.pdflumbarlateral recess stenosisendoscopic decompression |
| spellingShingle | Yip-kan Yeung Cheol-woong Park Su Gi Jun Jung-hoon Park Andy Choi-yeung Tse Comparative Cohort Study for Expansion of Lateral Recess and Facet Joint Injury after Biportal Endoscopic Ipsilateral Decompression and Contralateral Decompression Asian Spine Journal lumbar lateral recess stenosis endoscopic decompression |
| title | Comparative Cohort Study for Expansion of Lateral Recess and Facet Joint Injury after Biportal Endoscopic Ipsilateral Decompression and Contralateral Decompression |
| title_full | Comparative Cohort Study for Expansion of Lateral Recess and Facet Joint Injury after Biportal Endoscopic Ipsilateral Decompression and Contralateral Decompression |
| title_fullStr | Comparative Cohort Study for Expansion of Lateral Recess and Facet Joint Injury after Biportal Endoscopic Ipsilateral Decompression and Contralateral Decompression |
| title_full_unstemmed | Comparative Cohort Study for Expansion of Lateral Recess and Facet Joint Injury after Biportal Endoscopic Ipsilateral Decompression and Contralateral Decompression |
| title_short | Comparative Cohort Study for Expansion of Lateral Recess and Facet Joint Injury after Biportal Endoscopic Ipsilateral Decompression and Contralateral Decompression |
| title_sort | comparative cohort study for expansion of lateral recess and facet joint injury after biportal endoscopic ipsilateral decompression and contralateral decompression |
| topic | lumbar lateral recess stenosis endoscopic decompression |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2020-0656.pdf |
| work_keys_str_mv | AT yipkanyeung comparativecohortstudyforexpansionoflateralrecessandfacetjointinjuryafterbiportalendoscopicipsilateraldecompressionandcontralateraldecompression AT cheolwoongpark comparativecohortstudyforexpansionoflateralrecessandfacetjointinjuryafterbiportalendoscopicipsilateraldecompressionandcontralateraldecompression AT sugijun comparativecohortstudyforexpansionoflateralrecessandfacetjointinjuryafterbiportalendoscopicipsilateraldecompressionandcontralateraldecompression AT junghoonpark comparativecohortstudyforexpansionoflateralrecessandfacetjointinjuryafterbiportalendoscopicipsilateraldecompressionandcontralateraldecompression AT andychoiyeungtse comparativecohortstudyforexpansionoflateralrecessandfacetjointinjuryafterbiportalendoscopicipsilateraldecompressionandcontralateraldecompression |