Endoscopic Fenestration in Management of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study

Background Data: Minimally invasive fenestration has evolved recently to become the modern standard surgical solution for degenerative lumbar spinal canal stenosis (DLCS). Purpose: To investigate the safety and the efficacy of the endoscopic fenestration for patients with monosegmental degenerative...

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Autores principales:	Mohamed Hussein, Amr Eladawy, Tarek A El-Hewala
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2019
Materias:	endoscopic fenestration lumbar canal stenosis degenerative spine Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/8c7e85d17ee741a283920cd1ea987345
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spelling	oai:doaj.org-article:8c7e85d17ee741a283920cd1ea9873452021-12-02T02:18:15ZEndoscopic Fenestration in Management of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study10.21608/esj.2019.4534.10532314-89502314-8969https://doaj.org/article/8c7e85d17ee741a283920cd1ea9873452019-01-01T00:00:00Zhttps://esj.journals.ekb.eg/article_30586.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Minimally invasive fenestration has evolved recently to become the modern standard surgical solution for degenerative lumbar spinal canal stenosis (DLCS). Purpose: To investigate the safety and the efficacy of the endoscopic fenestration for patients with monosegmental degenerative lumbar spinal canal stenosis. Study Design: Prospective clinical cohort study. Patients and Methods: Thirty-five consecutive patients with DLCS were treated with endoscopic fenestration. Patients were treated with METRx system (Medtronic Sofamor Danek, Inc., Memphis, TN, USA), at Orthopedic Department, Zagazig University, between May 2012 and June 2015. Primary outcomes parameters included Numerical Rating Scale (NRS) for back and leg symptoms and Oswestry Disability Index (ODI) to quantify pain and disability, respectively. Secondary outcomes parameters included operative time, blood loss, preoperative and 3-month postoperative lumbar dynamic radiographs, and modified McNab criteria. Only patients who completed 36 months of follow-up were included in the final analysis of this study. Follow-up data were obtained from outpatient clinic follow-up visits by two independent physicians. Results: At the final follow-up, the improvement in claudicant leg pain and disability was statistically significant, and the endoscopic fenestration procedure did not affect the stability of the motion segment. The total success rate according to McNab criteria was 85.7% (30/35), fair 5.7% (2/35), and poor 8.6% (3/35). The mean NRS leg score significantly decreased from 7.3±1.5 preoperatively to 0.8±0.67 (P=0.001) postoperatively. The mean ODI score significantly decreased from 72.34±4.6 % preoperatively to 13.71±3.46 % postoperatively. There were no reported serious complications in any of our patients' study. Conclusion: Endoscopic fenestration is a safe and effective technique in patients with degenerative lumbar stenosis. It allows adequate decompression of the neural elements and preserves spinal stability. (2018ESJ145) Mohamed HusseinAmr EladawyTarek A El-HewalaEgyptian Spine Associationarticleendoscopicfenestrationlumbar canal stenosisdegenerative spineNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 29, Iss 1, Pp 34-45 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	endoscopic fenestration lumbar canal stenosis degenerative spine Neurology. Diseases of the nervous system RC346-429
spellingShingle	endoscopic fenestration lumbar canal stenosis degenerative spine Neurology. Diseases of the nervous system RC346-429 Mohamed Hussein Amr Eladawy Tarek A El-Hewala Endoscopic Fenestration in Management of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study
description	Background Data: Minimally invasive fenestration has evolved recently to become the modern standard surgical solution for degenerative lumbar spinal canal stenosis (DLCS). Purpose: To investigate the safety and the efficacy of the endoscopic fenestration for patients with monosegmental degenerative lumbar spinal canal stenosis. Study Design: Prospective clinical cohort study. Patients and Methods: Thirty-five consecutive patients with DLCS were treated with endoscopic fenestration. Patients were treated with METRx system (Medtronic Sofamor Danek, Inc., Memphis, TN, USA), at Orthopedic Department, Zagazig University, between May 2012 and June 2015. Primary outcomes parameters included Numerical Rating Scale (NRS) for back and leg symptoms and Oswestry Disability Index (ODI) to quantify pain and disability, respectively. Secondary outcomes parameters included operative time, blood loss, preoperative and 3-month postoperative lumbar dynamic radiographs, and modified McNab criteria. Only patients who completed 36 months of follow-up were included in the final analysis of this study. Follow-up data were obtained from outpatient clinic follow-up visits by two independent physicians. Results: At the final follow-up, the improvement in claudicant leg pain and disability was statistically significant, and the endoscopic fenestration procedure did not affect the stability of the motion segment. The total success rate according to McNab criteria was 85.7% (30/35), fair 5.7% (2/35), and poor 8.6% (3/35). The mean NRS leg score significantly decreased from 7.3±1.5 preoperatively to 0.8±0.67 (P=0.001) postoperatively. The mean ODI score significantly decreased from 72.34±4.6 % preoperatively to 13.71±3.46 % postoperatively. There were no reported serious complications in any of our patients' study. Conclusion: Endoscopic fenestration is a safe and effective technique in patients with degenerative lumbar stenosis. It allows adequate decompression of the neural elements and preserves spinal stability. (2018ESJ145)
format	article
author	Mohamed Hussein Amr Eladawy Tarek A El-Hewala
author_facet	Mohamed Hussein Amr Eladawy Tarek A El-Hewala
author_sort	Mohamed Hussein
title	Endoscopic Fenestration in Management of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study
title_short	Endoscopic Fenestration in Management of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study
title_full	Endoscopic Fenestration in Management of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study
title_fullStr	Endoscopic Fenestration in Management of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study
title_full_unstemmed	Endoscopic Fenestration in Management of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study
title_sort	endoscopic fenestration in management of monosegmental degenerative lumbar spinal canal stenosis: a clinical cohort study
publisher	Egyptian Spine Association
publishDate	2019
url	https://doaj.org/article/8c7e85d17ee741a283920cd1ea987345
work_keys_str_mv	AT mohamedhussein endoscopicfenestrationinmanagementofmonosegmentaldegenerativelumbarspinalcanalstenosisaclinicalcohortstudy AT amreladawy endoscopicfenestrationinmanagementofmonosegmentaldegenerativelumbarspinalcanalstenosisaclinicalcohortstudy AT tarekaelhewala endoscopicfenestrationinmanagementofmonosegmentaldegenerativelumbarspinalcanalstenosisaclinicalcohortstudy
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Endoscopic Fenestration in Management of Monosegmental Degenerative Lumbar Spinal Canal Stenosis: A Clinical Cohort Study

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