Abstract
Introduction Endoscopic techniques are being used in lumbar disk disease and lumbar canal stenosis
to decompress the spinal canal. The present study analyzed pre- and postoperative
magnetic resonance imaging (MRI) measurements of the lumbar canal.
Material and Methods This was a prospective study of 30 lumbar levels. Patients < 18 years of age with
unilateral compression, previous surgery at the same level, and spinal instability
were excluded. Endoscopic posterior decompression was used. Pre- and postoperative
MRIs of all the patients were performed. Anteroposterior (AP), transverse, interfacet
diameter, canal surface area, and height and angle of the lateral recess were measured.
Results Mean ages of male and female patients were 42.1 ± 10.3 and 45.0 ± 9.9 years, respectively.
Pathologies were at L4–L5, L5–S1, and L2–L3 levels in 16, 13, and 1 patient, respectively.
There was significant improvement in AP diameter (4.75 ± 1.75 mm to 10.33 ± 2.11 mm),
interfacet distance (12.70 ± 4.86 mm to 18.92 ± 3.53 mm), and canal surface area (76.45
± 25.36 mm2 to 187.13 ± 41.04 mm2) after decompression. Significant improvement was noted in mean height and angle
of lateral recess after surgery of both sides suggesting that effective decompression
of the bilateral canal was possible using a unilateral approach. Most of the patients
(90%) showed excellent and good improvement after surgery. Postoperative canal surface
area and AP diameter in patients who did not have any pain after surgery or had pain
requiring occasional medication was higher compared with patients who continued to
complain of pain and required continuous pain medication.
Conclusion Although the number of patients was small with a short follow-up, the endoscopic
technique was effective in improving AP diameter, interfacet distance, canal surface
area, lateral recess height, and lateral recess angle, suggesting that an endoscopic
technique using a unilateral approach is effective in bilateral decompression of neural
elements.
Keywords
endoscopic lumbar discectomy - lumbar disk disease - spinal stenosis - spondylosis
- surgical decompression
