Kapetanakis Stylianos, Gkantsinikoudis Nikolaos, Charitoudis Georgios
Spine Department and Deformities, Interbalkan European Medical Center, Thessaloniki, Greece
Department of Minimally Invasive and Endoscopic Spine Surgery, Athens Medical Center, Athens, Greece.
Int J Spine Surg. 2022 Apr;16(2):361-372. doi: 10.14444/8218.
Lateral recess stenosis (LRS) represents a major etiology of pain and disability in recent years. The aim of the present study was to compare the clinical outcomes of full-endoscopic ventral facetectomy (FEVF) vs conventional open laminectomy (OL) for surgical treatment of lumbar LRS.
Ninety individuals with diagnosed LRS according to clinical and radiological criteria were included in this study. Patients were appropriately classified into 2 distinct groups according to received treatment. Group A was constituted from 48 patients subjected to FEVF. Contrariwise, the 42 patients of Group B underwent OL. All patients were consecutively evaluated with particular clinical scores preoperatively and at 6 weeks, 3, months, 6 months, 12 months, and 2 years postoperatively. Clinical assessment was conducted with the visual analog scale for leg pain (VAS-LP) and back pain (VAS-BP) and with the Short-Form 36 (SF-36) medical questionnaire.
Values of all studied indices in both groups featured a major clinical improvement in 6 weeks with subsequent quantitatively minor albeit still statistically significant amelioration until the end of follow-up at 2 years. Comparative evaluation of recorded parameters between the 2 groups disclosed that VAS-BP, bodily pain, and role emotional indices of SF-36 were quantitatively and statistically differentiated in favor of Group A in 6 weeks, featuring an amelioration that persisted until the end of follow-up. Registered values of the other parameters were not found to demonstrate a quantitatively and clinically noteworthy differentiation between the 2 groups.
FEVF represents a feasible, safe, and beneficial alternative for surgical therapy of patients with LRS, featuring comparable outcomes with conventional OL.
Lumbar LRS represents a frequent entity with remarkable clinical sequelae. FEVF represents a novel, groundbreaking and minimally invasive technique that should be considered as a safe and efficacious alternative over conventional open surgery in specific patients with LRS.
侧隐窝狭窄（LRS）是近年来疼痛和残疾的主要病因。本研究的目的是比较全内镜下椎体后关节突切除术（FEVF）与传统开放性椎板切除术（OL）治疗腰椎LRS的临床疗效。
本研究纳入了90例根据临床和影像学标准诊断为LRS的患者。根据接受的治疗方法，患者被适当分为2个不同的组。A组由48例行FEVF的患者组成。相反，B组的42例患者接受了OL。所有患者在术前以及术后6周、3个月、6个月、12个月和2年时均连续接受特定的临床评分评估。使用腿痛视觉模拟量表（VAS-LP）和背痛视觉模拟量表（VAS-BP）以及简短健康调查问卷36项（SF-36）进行临床评估。
两组所有研究指标的值在6周时均有显著的临床改善，随后虽改善程度较小但直至2年随访结束时仍有统计学意义。两组记录参数的比较评估显示，VAS-BP、SF-36的身体疼痛和角色情感指数在6周时在数量和统计学上有利于A组，且这种改善持续至随访结束。未发现其他参数的记录值在两组之间有数量和临床上值得注意的差异。
FEVF是治疗LRS患者的一种可行、安全且有益的替代方法，其疗效与传统OL相当。
腰椎LRS是一种常见疾病，具有明显的临床后遗症。FEVF是一种新颖、开创性的微创技术，在特定的LRS患者中，应被视为比传统开放手术更安全有效的替代方法。
