Clinical Efficacy of Percutaneous Endoscopic Bilateral Decompression via Unilateral Interlaminar Approach in the Treatment of Degenerative Lumbar Spinal Stenosis

Abstract

To investigate the therapeutic effect of percutaneous endoscopic bilateral decompression via unilateral interlaminar approach in the treatment of degenerative lumbar spinal stenosis is the main objective. One hundred and thirty-eight patients with degenerative lumbar spinal stenosis admitted to our hospital from March 2018 to July 2020 were selected and divided into a control group and a trial group according to a randomized double-blind method, with 69 cases in each group. The control group was treated with laminectomy and decompression, while the trial group was treated with percutaneous endoscopic bilateral decompression via unilateral interlaminar approach. The Visual analogue scale score and Oswestry Disability Index were assessed before, on the first day after surgery and at the last postoperative follow-up (3 mo after surgery), and the patients were analyzed for postoperative complications, surgical indicators and overall efficacy using the modified MacNab criteria. In addition, the intervertebral space height index and the cross-sectional area of the spinal canal were measured pre and postoperatively in the operated segment and in the adjacent segment superior to the operated segment. The results showed that the operation time, bleeding volume, incision length and hospital stay of the study group were lower than those of the control group, and the differences were statistically significant (p<0.05, respectively. And the excellent rate of the study group was higher than that of the control group, and the difference was significant (p<0.05). In addition, there was no significant difference in Visual Analogue Scale score and Oswestry Disability Index between the two groups before operation. After operation, the Visual Analogue Scale score and Oswestry Disability Index of the two groups were both significantly improved, and the Visual Analogue scale score and Oswestry Disability Index of the study group were lower than those of the control group, and the differences were significant (p<0.05, respectively). What’s more, the incidence of complications in the study group was lower than that in the control group (p<0.05). The results also indicated that at the last follow-up, there were no significant differences in intervertebral height index before and after operation in the both operated segment and the superior adjacent segment (p>0.05). In addition, at the last follow-up, the cross-sectional area of the spinal canal of the operated segment was significantly increased, and the improvement was more obvious in the study group than the control group, and the difference was statistically significant (p<0.05). However, there was no significant increase in the superior adjacent segment compared with that before operation (p>0.05). Percutaneous endoscopic bilateral decompression via unilateral interlaminar approach has the advantages of minimal trauma, precise decompression and rapid recovery in improving degenerative lumbar spinal stenosis, with good recent results.