Houra Karlo, Saftic Robert, Klaric Emil, Knight Martin
Aksis Specialty Hospital for Spinal and Orthopedic Surgery, Zagreb, Croatia
University North - University Center Varaždin, Varaždin, Croatia.
Int J Spine Surg. 2022 Feb;16(1):139-150. doi: 10.14444/8182. Epub 2022 Feb 17.
The aim of this study is to evaluate the safety and long-term clinical outcomes of transforaminal endoscopic foraminoplasty using local anesthesia and total intravenous analgesia (TIVA) in patients with single-level lumbar foraminal stenosis and unilateral leg pain.
Postoperative pain relief was self-evaluated by 46 consecutive patients using a visual analog scale (VAS) and Oswestry Disability Index (ODI). Patient scores were obtained before the procedure and at 6, 12, 24, and 60 months after surgery.
Pain reduction of at least 50% in the VAS score and a decrease of at least 50% or more in ODI score was achieved in 37 of 46 patients throughout the follow-up period. Median VAS score decreased from 7.5 preoperatively to 2.5 postoperatively. Median ODI score decreased from 62% preoperatively to 15% postoperatively. All patients reached 24-month follow-up and 37 patients reached 60-month follow-up. There were no surgery-related complications.
Transforaminal endoscopic foraminoplasty performed under local anesthesia and TIVA produces sustained reduction in pain and improves functionality in patients with single-level lumbar foraminal stenosis without complications even in patients with comorbidities.
Endoscopic foraminoplasty may be a useful adjunct to open micro decompressive surgery for patients with foraminal stenosis of the lumbar spine LEVEL OF EVIDENCE: 4.
本研究旨在评估在局部麻醉和全静脉镇痛(TIVA)下进行经椎间孔内镜下椎间孔成形术治疗单节段腰椎椎间孔狭窄并单侧腿痛患者的安全性和长期临床疗效。
46例连续患者使用视觉模拟量表(VAS)和Oswestry功能障碍指数(ODI)对术后疼痛缓解情况进行自我评估。在手术前以及术后6、12、24和60个月获取患者评分。
在整个随访期间,46例患者中有37例VAS评分至少降低50%,ODI评分降低至少50%或更多。VAS评分中位数从术前的7.5降至术后的2.5。ODI评分中位数从术前的62%降至术后的15%。所有患者均完成24个月随访,37例患者完成60个月随访。无手术相关并发症。
在局部麻醉和TIVA下进行经椎间孔内镜下椎间孔成形术可使单节段腰椎椎间孔狭窄患者的疼痛持续减轻,功能改善,即使是合并症患者也无并发症。
内镜下椎间孔成形术对于腰椎椎间孔狭窄患者可能是开放显微减压手术的有用辅助手段。证据级别:4级。