The Clinical Research Study On Foraminoplastic And Percutaneous Endoscopic Lateral Recess Decompression Through Transforaminal Approach For Lumbar Lateral Recess Syndrome

Objective:To retrospectively explore the early clinical outcomes and influencing factors of foraminoplastic and percutaneous endoscopic lateral recess decompression through transforaminal approach.Methods:From October 2014 to September 2016,72 patients with lumbar lateral recess syndrome treated by using percutaneous transforaminal endoscopic,including35 males and 37 females with an average age of 55.4 ± 7.2years.The neurogenic intermittent claudication accompanied by a side nerve root compression syndrome was presented in all patients with lateral radius vector is less than 3 mm examinated by preoperative CT.Preoperative and postoperative 3 days,1 month,3 months,6months using visual analogue scale(VAS)and Oswestry disability index(ODI)to evaluate patient’s pain and lumbar function,after 6 months according to the modified Mac Nab evaluation standard to evaluate surgical curative effect.8 kinds of factors that may affect the postoperative clinical efficacy was performed by Correlation analysis.Results:All the procedures were successfully performed in local anesthesia without transformation to other surgical method.There are 5 patients with poor clinical outcomes went through reoperation,of which 2 cases recurrence,3 cases with insufficient decompression.Only 3 case of spinal dura mater tear and 1 bleeding intraoperatively was revised.Fortunately,no nerve injuries,organs trauma,infections or other severe consequence was noticed.After operation 3 days,1 month,3 months,6months,the VAS score and ODI scores compared with preoperative were improved significantly(P<0.05).The lateral radius vector examinated by preoperative CT after3 days and 6 months were expanded compared with preoperative,and the change wasstatistically significant(P<0.05).The excellent and good rate was 84.7% and the total effective rate was 93.1%,according to the Mac Nab evaluation standard(excllent:32,good:29,fair:6,bad:5).Correlation analysis show that age,course of the disease,preoperative claudication distance and degree of intervertebral disc degeneration were significantly correlated with the clinical efficacy(P<0.05),there was no significant statistical differences in gender,operation segments,joints degenerative degree and the degree of lateral recess stenosis(P>0.05).Conclusion:Foraminoplastic and percutaneous transforaminal endoscopic lateral recess decompression is safe and effective,it can be used as a minimally invasive treatment symptoms and lateral radius vector may influence the early clinical outcomes of foraminoplastic and percutaneous transforaminal endoscopic lateral recess decomprssion for lumbar lateral recess syndrome.