Efficacy of percutaneous transforaminal endoscopic spine system in the treatment of elderly patients with lumbar lateral recess stenosis

ObjectiveTo analyze the clinical efficacy of percutaneous transforaminal endoscopic spine system (TESSYS) in the treatment of elderly patients with lumbar lateral recess stenosis. MethodsA total of 25 elderly patients with lumbar lateral recess stenosis were performed percutaneous endoscopic decompression via transforaminal approach. There were 15 men and 10 women, with an average age of 71.12 years ranging from 61 to 88 years. The course of disease was 6 months to 5 years (10.1 months on the average) and the follow-up time was 12 to 24 months (16.5 months on the average). All patients presented back pain and sciatica to various degrees, in addition to stenosis in the lateral recess and lumbar intervertral foramen. Surgery was performed under local anesthesia. Percutaneous lumbar intentertebral foramen approach for decompression of lateral recess and treatment of intervertebral foramen were used on all cases. The surgical effect was evaluated using the MacNab scores six months after operation. The preoperative and postoperative visual analogue scale (VAS) on Day 1, and 3, 6 months after operation were used to evaluate leg pain, and the Oswestry disability index (ODI) was also evaluated. ResultsAll operations were successfully carried out. The operation time was 55 to 110 min (average 70 min) and the blood loss was 10 to 40 ml (average 19 ml). One case was complicated with leg pain recurrence after discharge and relieved by conservative therapy. After operation, the VAS of sciatica was decreased from (8.31±1.81) before operation, to (3.11±0.82) on Day 1 after operation, (1.80±0.36) on 3 months after operation and (1.54±0.35) 6 months after operation. The postoperative VAS scores of sciatica were significantly decreased compared with preoperative VAS scores (P＜0.01). ODI was decreased from (66.3±9.8) before operation to (18.07±4.30) 6 month after operation. According to MacNab criteria, the surgical outcomes were excellent in 10 (40%) cases, good in 14 (56%) cases, fair in 1 (4%) case, with an excellent-to-good rate of 96% (P＜0.01). ConclusionsPercutaneous TESSYS can treat elderly patients with degenerative lumbar spinal stenosis, with little trauma and complications. This technique can be performed under local anesthesia and has less impact on the general condition of patients. TESSYS gives advantage to the remedy of patients accompanied with stenosis in lateral recess.