| Objective:The purpose of this study is to evaluate the efficacy of percutaneous transforaminal endoscopic decompression for the treatment of lumbar spinal stenosis,calculate the incidence of complications,analyze the causes of complications and summarize the treatment methods,so as to reduce the occurrence of surgical complications in the future clinical work and adopt effective coping strategies.Methods:From April 2017 to April 2019,101 patients with lumbar spinal stenosis received percutaneous transforaminal endoscopic decompression performed by the author’s tutor in our department.Two patients were lost because they changed their contact information and one patient died of natural causes during follow-up.98 patients were followed up for one year.Among these patients,39 were males and 59 were females,with a mean age of66.94±10.11 years(range 40-87 years).The distribution of surgical segments was as follows: L2-L3:1 case,L3-4:7 cases,L4-5:71 cases,L5-S1:15 cases,double levels of L3-4 and L4-5:3 cases,L4-5 and L5-S1:1 case.Visual Analog Scale(VAS)and Oswestry Disability Index(ODI)were recorded preoperatively,three months,six months and one year after surgery,respectively,for statistical analysis.The intraoperative and postoperative complications and their management measures were recorded,and the causes of complications were analyzed.Clinical efficacy was assessed using the modified Mac Nab standard at the last follow-up.Results:1.The postoperative VAS and ODI scores of the 98 patients at 3,6 and 12 months were significantly lower than those before surgery(P < 0.05).The rate of excellent and good in the last follow-up was 90.82%.2.Intraoperative and postoperative complications occurred in 14 patients(14.29%),including nerve root injury in 3 cases(3.06%),incomplete decompression in 1 case(1.02%),postoperative lumbar disc herniation 1case(1.02%),transient recurrence of symptoms in 2 cases(2.04%),postoperative paraesthesia in 2 cases(2.04%),dural tear in 1 case(1.02%),neck pain and discomfort in 3 cases(3.06%),lumbar disc pseudocyst in 1case(1.02%).Conclusion:The efficacy of percutaneous transforaminal endoscopic decompression for the treatment of lumbar spinal stenosis is satisfactory,and there is a certain incidence of complications.The complications are mainly related to the complicated anatomical structure of the surgical segments,the improper operation by the operator and the long operation time.Corresponding treatment for different complications can effectively alleviate the symptoms of patients. |
