Degenerative lumbar spinal canal stenosis surgery by endoscopy approach

Аннотация

Lumbar degenerative spinal canal stenosis (LDSS) is a prevalent condition that significantly impacts the quality of life of patients, leading to substantial economic costs in the healthcare system. It is commonly observed in individuals aged over 50 and is primarily caused by degenerative disc disease. Traditional treatment options, including laminectomy, come with potential complications, including nerve damage, infection, and prolonged recovery times. An emerging alternative is percutaneous spinal lumbar decompression (PSLD), a minimally invasive procedure that aims to reduce these complications while improving clinical outcomes. Methods: The study was conducted at the Republican Center of Traumatology and Orthopedics in Uzbekistan from 2020 to 2025. A total of 50 patients diagnosed with lumbar spinal stenosis were included in the analysis. The patients were divided into two groups: the endoscopic PSLD group (n=27) and the traditional decompressive surgery group (n=23). All patients underwent preoperative assessments using radiography, multislice computed tomography (MSCT), and magnetic resonance imaging (MRI) to evaluate spinal canal dimensions, foraminal opening size, and the severity of stenosis. Visual Analog Scale (VAS) used for evaluation of pain. Statistical analyses, including t-tests and chi-square tests, were used to compare outcomes between the two groups, with a significance level set at p<0.05. Results: The mean age of patients in the endoscopic PSLD group was 56.86 ± 7.7 years, and in the traditional surgery group, it was 54.25 ± 5.08 years, with no significant difference observed between the two groups in terms of age. Postoperatively, the mean VAS score for the traditional surgery group was 3.8 (SD=0.96), while for the endoscopic PSLD group, it was significantly lower at 2.51 (SD=1.01), indicating that the PSLD group experienced significantly less postoperative pain (p<0.05). Conclusion: This study demonstrates that endoscopic PSLD is a promising alternative to traditional decompressive surgery for the treatment of lumbar stenosis. The procedure offers significant advantages in terms of postoperative pain relief and reduced recovery time, making it a favorable option for patients. Keywords: Lumbar spinal stenosis, endoscopic PSLD, Visual Analog Scale (VAS), degenerative disc disease, lumbar decompression surgery. between 11–39% based on clinical diagnoses and 11– Introduction: Lumbar degenerative spinal canal 38% based on radiological data [6]. The frequency of stenosis is a significant medical and social problem that lumbar spinal stenosis increases sharply in individuals affects the quality of life of patients and imposes a over 50 years of age, reaching between 1.8% and 8% in substantial economic burden on the healthcare system this age group. According to Danish studies, lumbar due to the complexities of treatment. The prevalence spinal stenosis occurs at a rate of 272 cases per of lumbar spinal canal stenosis is estimated to be International Journal of Medical Sciences And Clinical Research 105 https://theusajournals.com/index.php/ijmscr International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265) 1,000,000 population per year [5]. Such patients outcomes and the long-term quality of life of the complain of a "burning, aching, twisting" sensation, and patient. even minimal irritation can trigger a burning pain. Due to these drawbacks, the use of the percutaneous Another classic symptom of lumbar spinal stenosis is spinal lumbar decompression (PSLD) method, episodes of painful muscle spasms (cramps) in the calf developed by South Korean neurosurgeon Dr. Kim Taek or foot area [7, 11]. The complexity of the disease lies Lim, represents an optimal approach for treating this in the fact that the symptoms significantly impact the pathology. This method employs a minimally invasive quality of life of patients. Among patients with a interlaminar decompression technique, effectively combination of leg and lower back pain, 70% report relieving pressure on nerve roots and the spinal canal, equal intensity of pain in both areas, while in 58% of while significantly reducing recovery time and cases, the pain is localized to one leg, and in 42%, it is minimizing risks associated with open surgery. bilateral 12% [5]. When walking and standing, these The interlaminar decompression method within PSLD patients exhibit signs of cauda equina root dysfunction: involves the removal of only the tissues that directly bilateral radicular pain, sensory disturbances, and compress nerve structures, ensuring a more precise decreased muscle strength in the legs. When the and gentle intervention. This also reduces the patient lies down, these symptoms resolve quickly, and likelihood of complications such as nerve root damage, neurological examination in the lying position does not infection, or excessive bleeding [2]. reveal any abnormalities. Myelography shows a block with signs of extradural co