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Bilateral Operation of Lumbar Degenerative Central Spinal Stenosis in Full-endoscopic Interlaminar Technique With Unilateral Approach: Prospective 2-year Results of 74 Patients

Komp, Martin MD*; Hahn, Patrick MD*; Merk, Harry MD; Godolias, Georgios MD; Ruetten, Sebastian MD*

Journal of Spinal Disorders & Techniques: July 2011 - Volume 24 - Issue 5 - p 281–287
doi: 10.1097/BSD.0b013e3181f9f55e
ORIGINAL ARTICLES

Study Design Prospective study of the patients with degenerative spinal central stenosis, operated bilateral in a full-endoscopic unilateral technique.

Objective The objective of this prospective study was to examine the technical possibilities of full-endoscopic interlaminar bilateral technique with unilateral approach in degenerative lumbar central spinal stenosis and predominant leg symptoms using new designed endoscopes and instruments.

Summary of Background Data Extensive decompression with laminectomy where appropriate, is often still described as the method of choice in the operation of degenerative lumbar spinal stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the advantages they offer in surgical technique and in rehabilitation. At the spine, 1 essential point was the developing of the instruments for sufficient bone resection under continuous visual control. This enabled the use in the operation of spinal canal stenoses.

Methods A total of 72 patients with lumbar central spinal stenosis full-endoscopic unilateral decompression were followed for 2 years. In addition to general and specific parameters, these measuring instruments were used: VAS, German version North American Spine Society Instrument, Oswestry Low-back Pain Disability Questionnaire.

Results The results show that 70.8% no longer have leg pain or it was nearly completely reduced and 22.2% have occasional pain. The decompression results were equal to those of conventional procedures. The complication rate was low. The full-endoscopic techniques brought advantages in these areas: operation, complications, traumatization, and rehabilitation.

Conclusions The recorded results show that the full-endoscopic interlaminar bilateral decompression with unilateral approach is a sufficient and safe supplement and alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.

*Department of Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology, St. Anna-Hospital Herne, University of Witten/Herdecke, Herne

Clinic for Orthopaedics and Orthopaedic Surgery, Ernst Moritz Arndt University Greifswald, Greifswald, Germany

Center for Orthopaedics and Traumatology, St. Anna-Hospital Herne, University of Witten/Herdecke, Herne

Sources of Support: No.

Reprints: Martin Komp, MD, Vice-Head Department of Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology, St. Anna-Hospital Herne, Hospitalstrasse 19, 44649 Herne, Germany (e-mail: komp@annahospital.de).

Received July 17, 2010

Accepted August 28, 2010

© 2011 Lippincott Williams & Wilkins, Inc.