Therapeutic effects of full endoscopic spine surgery via transforaminal approach in elderly patients with lumbar spinal stenosis: A retrospective clinical study

Özet

Objective: This study aimed to investigate the therapeutic effects of full endoscopic spine surgery on clinical and radiologicaloutcomes in elderly patients over 70 years with lumbar spinal stenosis, without any obvious segmental instability.Methods: A total of 47 patients (27 males, 20 females; the mean age=74.23±5.16) above 70 years who underwent a transforaminalpercutaneous endoscopic decompression with the diagnosis of lumbar spinal stenosis, were included in this retrospective study.The mean follow-up was 26±2.97 months. The clinical efficacy of the surgical procedure was assessed by the Oswestry disabilityindex (ODI) and the visual analog scale (VAS) of the leg and lower back at 1 week, 3 months, and 1 year postoperatively, andat the final follow-up examination. Modified MacNab criteria was also performed to assess the clinical efficiency of surgery atthe final follow-up.Results: An excellent outcome as per modified MacNab criteria was obtained in 9 patients (19.1%), a good outcome in 33patients (70.2%), a fair outcome in 3 patients (6.4%), and poor results in 2 patients (4.3%). The mean ODI score significantly improved from 71.29±5.69 preoperatively to 32.05±10.71 at postoperative 1 week, 30.27±9.89 at 3 months, 27.23±8.47 at 1 year, and23.11±9.97 at the final follow-up (p<0.05 for each evaluation point). The mean VAS score of the leg and lower back significantlydecreased from 6.10±0.96 and 5.71±1.13 preoperatively to 1.69±0.96, 2.24±1.01 at postoperative 1 week, 1.69±0.84, 2.45±0.87 at3 months, 1.71±0.81, 2.38±0.79 at 1 year, and 1.71±0.92, 2.48±0.67 at the final follow-up, respectively (p<0.05 for each evaluationterm). Postoperative computed tomography or magnetic resonance imaging showed adequate decompression of the central orlateral recess and removal of combined herniated discs.Conclusion: The results of our preliminary study have demonstrated that full endoscopic spine surgery is a safe and efficienttechnique for the therapy of neurogenic claudication and radiculopathy in elderly patients with lumbar spinal stenosis.Level of Evidence: Level IV, Therapeutic Study