Early Efficacy Of Transforaminal Spinal Endoscopy In The Treatment Of Degenerative Lumbar Spinal Stenosis

Objective:The purpose of this study was to study the clinical feasibility and safety of percutaneous foraminal decompression in the treatment of degenerative lumbar spinal stenosis.Methods : From September 2016 to October 2018,64 patients with degenerative lumbar spinal stenosis in the orthopaedic ward of the first affiliated hospital of Guangxi University of traditional Chinese medicine were retrospectively analyzed.According to the operation method,group A(observation group)was treated by percutaneous foramen technique,group B(control group)was treated by traditional interlaminar fenestration decompression,and visual analogue score(VAS),)was used.The efficacy was assessed and compared by Oswestry Disability Index(ODI),modified Macnab classification in Oswestry dysfunction index questionnaire.Using SPSS 20.0 software to analyze the results in row analysis.Results All patients were performed by the same group of physicians and the procedure was smooth.There was no significant difference in sex,age,course of disease and responsibility segment between the two groups(P > 0.05),there was no significant difference in the operation time between the two groups(P > 0.05).The operative incision length and hospital stay in group A were significantly shorter than those in group B(P < 0.05).The VAS scores of lumbago and leg pain measured before operation,post-operation 1 day,post-operation 3 months,post-operation 6 months and the last follow-up were compared between the two groups.The VAS scores of lumbago and leg pain in both groups were significantly lower than those before operation(P < 0.05).There was interaction between operation mode and time on VAS score of lumbago and leg pain(P < 0.001).The main effect of operation mode onVAS score of lumbago and leg pain was significant(P < 0.001).Time had significant effect on VAS score of lumbago and leg pain(P < 0.001).The VAS score of low back pain in group A was significantly lower than that in group B at post-operation 1 day and post-operation 3 months(P < 0.05).The VAS score of low back pain in group A was significantly lower than that in group B at post-operation 6 months and at the last follow-up(P > 0.05).The VAS score of leg pain in group A was lower than that in group B at post-operation 1 day,post-operation 3 months and post-operation 6months,The difference was statistically significant(P < 0.05).At the last follow-up,the VAS score of leg pain in the two groups was similar,but there was no significant difference between the two groups(P > 0.05).The ODI index at each time point after operation in the two groups was significantly lower than that pre-operation,and the difference was statistically significant(P < 0.05).The effect of operation mode and time on ODI index was significant(P < 0.001),the main effect of operation mode on ODI index was significant(P < 0.001),and the influence of time on ODI index was significant(P < 0.001).The ODI index of group A was lower than that of group B at post-operation 1 day,post-operation 3 months and post-operation 6 months(P < 0.05).At the last follow-up,the ODI index of the two groups was similar,but there was no significant difference between the two groups(P > 0.05).The excellent and good rate of group A was 93.9% and the excellent and good rate of group B was 90.3%.There was no significant difference in the incidence of postoperative complications between the two groups(P > 0.05).Conclusions 1.Early efficacy of percutaneous transforaminal spinal endoscopy in the treatment of degenerative lumbar spinal stenosis is comparable to traditional interlaminar fenestration and decompression.2.Percutaneous transforaminal spinal endoscopy is an effective minimally invasive technique for the treatment of degenerative lumbar spinal stenosis.