Ahn Yong, Jung Jun-Hyeok
Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea.
J Clin Med. 2024 Jan 17;13(2):515. doi: 10.3390/jcm13020515.
The incidence of radiculopathy due to lumbar spinal stenosis has been on the increase in the aging population. However, patients aged ≥ 80 years hesitate to undergo conventional open surgery under general anesthesia because of the risk of postoperative morbidity and adverse events. Therefore, less invasive surgical alternatives are required for the elderly or medically handicapped patients. Transforaminal endoscopic lumbar lateral recess decompression (TELLRD) may be helpful for those patients. This study aimed to demonstrate the efficacy of TELLRD for treating radiculopathy in octogenarian patients. A total of 21 consecutive octogenarian patients with lumbar foraminal stenosis underwent TELLRD between January 2017 and January 2021. The inclusion criterion was unilateral radiculopathy, which stemmed from lumbar lateral recess stenosis. The pain source was verified using imaging studies and selective nerve blocks. Full-scale lateral canal decompression was performed using a percutaneous transforaminal endoscopic approach under local anesthesia. We found the pain scores and functional status improved significantly during the 24-month follow-up period. The clinical improvement rate was 95.24% (20 of 21 patients) with no systemic complication. In conclusion, endoscopic lateral recess decompression via the transforaminal approach is practical for octogenarian patients.
在老龄化人群中，腰椎管狭窄症所致神经根病的发病率一直在上升。然而，80岁及以上的患者由于术后发病风险和不良事件而不愿接受常规的全身麻醉下开放手术。因此，对于老年患者或身体有残疾的患者，需要侵入性较小的手术替代方案。经椎间孔内镜下腰椎侧隐窝减压术（TELLRD）可能对这些患者有所帮助。本研究旨在证明TELLRD治疗八旬患者神经根病的疗效。2017年1月至2021年1月期间，共有21例连续的八旬腰椎椎间孔狭窄患者接受了TELLRD。纳入标准为源于腰椎侧隐窝狭窄的单侧神经根病。使用影像学研究和选择性神经阻滞来确定疼痛来源。在局部麻醉下，采用经皮椎间孔内镜入路进行全范围侧隐窝减压。我们发现，在24个月的随访期内，疼痛评分和功能状态有显著改善。临床改善率为95.24%（21例患者中的20例），无全身并发症。总之，经椎间孔入路的内镜下侧隐窝减压术对八旬患者是可行的。
