Effect of Percutaneus Endoscopic Interlaminar Decompression in Treatment of Lumbar Lateral Recess Stenosis in Elderly Patients
LI Zhi-da,XIE Jing-kai,PENG Xiao-mei
Department of Orthopaedics, Zhanjiang Lingnan Hospital, Zhanjiang Development Zone, Guangdong Province, Zhanjiang (524001), China;Department of Orthopaedics, Second People's Hospital of Foshan City, Guangdong Province (Foshan 528000)
Abstract:
Objective To investigate the clinical effect of percutaneus endoscopic interlaminar decompression in treatment of lumbar lateral recess stenosis in elderly. Methods Elderly patients with lumbar lateral recess stenosis (196 cases) were randomly divided into observation group and control group, 98 cases in each group. The observation group underwent percutaneus endoscopic interlaminar decompression. The control group underwent percutaneous endoscopic decompression. The degree of lower extremity pain was assessed by visual analogue scale (VAS) before surgery, 7 d, 1 month and 3 months after surgery. The Oswestry disability index (ODI) was used to assess lumbar function. The degree of crypt stenosis was assessed by crypt angle. The surgical outcomes of the two groups were assessed according to the MacNab criteria, and surgical complications were recorded. Results The VAS and ODI scores of the 2 groups were lower than those before operation (P<0.05) and observation group was lower than control group. Soft lateral crypt angle [(30.53±9.76)? and (27.27±8.39)?], skeletal lateral crypt angle [(33.18±10.36)? and 31.52±9.85)?] were greater than preoperative [soft side crypt angle: (14.26±7.92)?, (14.51±6.83)?; skeletal side crypt angle: (16.63±6.58)?, (17.02±7.73)?] (P<0.05), and the observation group was larger than the control group. The excellent rates of the observation group (94%) and control group ( 89%) were not significantly different (P > 0 . 05). There was no nerve root tear and serious complications such as permanent nerve injury in two groups. Conclusion Compared with percutaneous endoscopic decompression, percutaneus endoscopic interlaminar decompression is effective in reducing lower extremity pain and improving lateral recess stenosis and lumbar function in elderly patients with lumbar stenosis.
