요추부 추간공 협착증에서 수술 현미경과 원통형 견인장치를 이용한 추간공 확장술의 효율성: 수술 기법과 임상적 결과 = Efficacy of Microdecompression with Microscope and Tubular Retractor in Lumbar Foraminal Stenosis: Surgical Technique and Clinical Outcomes

다국어 초록 (Multilingual Abstract)

Objective: The objective of this study is to evaluate the efficacy of microdecompression (MD) with microscope and tubular
retractor in lumbar foraminal stenosis (FS) and to analyze the clinical outcomes.
Methods: From January 2006 to December 2007, 22 patients with symptomatic lumbar FS underwent conventional
decompressive surgery (CDS) and MD was performed in other 20 patients. Clinical outcome was measured using a Visual
Analogue Scale (VAS) and Macnab’s criteria. Spinal instability was determined by radiologic assessment of flexion‐extension
radiographs.
Results: The CDS group included 14 men and 8 women. The MD group included 14 men and 6 women. The mean
age was 66.2 years (range, 46-80 yrs) in the CDS group and 65.4 years (range, 59-74 yrs) in the MD group. Average
follow‐up periods were 18.6 months in the CDS group and 16.5 months in the MD group. Mean operating time
was 126 minutes in the CDS group and 168 minutes in the MD group. The mean VAS of back pain decreased from
2.68 to 1.36 in the CDS group and from 2.85 to 1.25 in the MD group. The mean VAS score of leg pain decrea- sed
from 6.68 to 1.48 in the CDS group and from 6.65 to 1.40 in the MD group. The success rate of CDS group was 86.3
% (19/22), compared with 85.0% (17/20) for MD group. Radiologically, there was no spinal instability.
Conclusion: MD could achieve neural decompression and offer an effective treatment of lumbar FS. However it was a
technically demanding procedure and effective in limited operative indications. We need to consider long‐term follow‐up.

다국어 초록 (Multilingual Abstract)

Objective: The objective of this study is to evaluate the efficacy of microdecompression (MD) with microscope and tubular
retractor in lumbar foraminal stenosis (FS) and to analyze the clinical outcomes.
Methods: From January 2006 to December 2007, 22 patients with symptomatic lumbar FS underwent conventional
decompressive surgery (CDS) and MD was performed in other 20 patients. Clinical outcome was measured using a Visual
Analogue Scale (VAS) and Macnab’s criteria. Spinal instability was determined by radiologic assessment of flexion‐extension
radiographs.
Results: The CDS group included 14 men and 8 women. The MD group included 14 men and 6 women. The mean
age was 66.2 years (range, 46-80 yrs) in the CDS group and 65.4 years (range, 59-74 yrs) in the MD group. Average
follow‐up periods were 18.6 months in the CDS group and 16.5 months in the MD group. Mean operating time
was 126 minutes in the CDS group and 168 minutes in the MD group. The mean VAS of back pain decreased from
2.68 to 1.36 in the CDS group and from 2.85 to 1.25 in the MD group. The mean VAS score of leg pain decrea- sed
from 6.68 to 1.48 in the CDS group and from 6.65 to 1.40 in the MD group. The success rate of CDS group was 86.3
% (19/22), compared with 85.0% (17/20) for MD group. Radiologically, there was no spinal instability.
Conclusion: MD could achieve neural decompression and offer an effective treatment of lumbar FS. However it was a
technically demanding procedure and effective in limited operative indications. We need to consider long‐term follow‐up.

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