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      KCI등재 SCIE SCOPUS

      Treatment of Soft Tissue and Bony Spinal Stenosis by a Visualized Endoscopic Transforaminal Technique Under Local Anesthesia

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      https://www.riss.kr/link?id=A106106520

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      다국어 초록 (Multilingual Abstract)

      Objective: To analyze long-term clinical outcomes of endoscopic transforaminal foraminoplasty for foraminal stenosis. Methods: Long-term 5-year MacNab outcomes, visual analogue scale (VAS) scores, complications, and unintended aftercare were analyzed...

      Objective: To analyze long-term clinical outcomes of endoscopic transforaminal foraminoplasty for foraminal stenosis.
      Methods: Long-term 5-year MacNab outcomes, visual analogue scale (VAS) scores, complications, and unintended aftercare were analyzed in a series of 86 patients who underwent endoscopic transforaminal foraminoplasty for foraminal stenosis.
      Results: At minimum 5-year follow-up, excellent results according to the MacNab criteria were obtained in 32 patients (37.2%), Good in 40 (46.5%), fair in 11 (12.8%), and poor in 3 (3.5%), respectively. The mean preoperative VAS was 6.15. The mean postoperative and last follow-up VAS was 3.44. Both postoperative VAS and last follow-up VAS were statistically reduced at a significance level of p<0.0001. Postoperative dysesthesia occurred in 9 patients. Another 9 patients had recurrent disc herniations (10.5%). Failure to cure with persistent pain occurred in 3 patients. Two patients developed pain postoperatively stemming from a different level. One patient experienced a postoperative hematoma which ultimately was inconsequential and did not require any additional surgery. Only 3 patients opted for revision endoscopic discectomy and another 2 for revision fusion surgery.
      Conclusion: Patients with symptomatic foraminal stenosis may be treated successfully with early transforaminal endoscopic decompression while maintaining favorable long-term outcomes without the need for fusion in the vast majority of patients.

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      참고문헌 (Reference)

      1 Lewandrowski KU, "“Outside-in” technique, clinical results, and indications with transforaminal lumbar endoscopic surgery:a retrospective study on 220 patients on applied radiographic classification of foraminal spinal stenosis" 8-, 2014

      2 O'Lynnger TM, "Trends for spine surgery for the elderly: implications for access to healthcare in North America" 77 (77): S136-S141, 2015

      3 Sibbald M, "The biasing effect of clinical history on physical examination diagnostic accuracy" 45 : 827-834, 2011

      4 Yeung AT, "The Yeung percutaneous endoscopic lumbar decompressive technique(YESSTM)" 7 : 408-, 2018

      5 Lewandrowski KU, "Successful outcome after outpatient transforaminal decompression for lumbar foraminal and lateral recess stenosis : The positive predictive value of diagnostic epidural steroid injection" 173 : 38-45, 2018

      6 Jenis LG, "Spine update. Lumbar foraminal stenosis" 25 : 389-394, 2000

      7 Bogduk N, "Spinal care: diagnosis and treatment" Mosby 322-343, 1995

      8 Lewandrowski KU, "Retrospective analysis of accuracy and positive predictive value of preoperative lumbar MRI grading after successful outcome following outpatient endoscopic decompression for lumbar foraminal and lateral recess stenosis" 179 : 74-80, 2019

      9 Asch HL, "Prospective multiple outcomes study of outpatient lumbar microdiscectomy:should 75 to 80% success rates be the norm?" 96 (96): 34-44, 2002

      10 Holm S, "Pathophysiology of disc degeneration" 251 : 13-15, 1993

      1 Lewandrowski KU, "“Outside-in” technique, clinical results, and indications with transforaminal lumbar endoscopic surgery:a retrospective study on 220 patients on applied radiographic classification of foraminal spinal stenosis" 8-, 2014

      2 O'Lynnger TM, "Trends for spine surgery for the elderly: implications for access to healthcare in North America" 77 (77): S136-S141, 2015

      3 Sibbald M, "The biasing effect of clinical history on physical examination diagnostic accuracy" 45 : 827-834, 2011

      4 Yeung AT, "The Yeung percutaneous endoscopic lumbar decompressive technique(YESSTM)" 7 : 408-, 2018

      5 Lewandrowski KU, "Successful outcome after outpatient transforaminal decompression for lumbar foraminal and lateral recess stenosis : The positive predictive value of diagnostic epidural steroid injection" 173 : 38-45, 2018

      6 Jenis LG, "Spine update. Lumbar foraminal stenosis" 25 : 389-394, 2000

      7 Bogduk N, "Spinal care: diagnosis and treatment" Mosby 322-343, 1995

      8 Lewandrowski KU, "Retrospective analysis of accuracy and positive predictive value of preoperative lumbar MRI grading after successful outcome following outpatient endoscopic decompression for lumbar foraminal and lateral recess stenosis" 179 : 74-80, 2019

      9 Asch HL, "Prospective multiple outcomes study of outpatient lumbar microdiscectomy:should 75 to 80% success rates be the norm?" 96 (96): 34-44, 2002

      10 Holm S, "Pathophysiology of disc degeneration" 251 : 13-15, 1993

      11 Rauschning W, "Pathoanatomy of lumbar disc degeneration and stenosis" 251 : 3-12, 1993

      12 Rauschning W, "Normal and pathologic anatomy of the lumbar root canals" 12 : 1008-1019, 1987

      13 Macnab I., "Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients" 53 : 891-903, 1971

      14 Sengupta DK, "Lumbar spinal stenosis. Treatment strategies and indications for surgery" 34 : 281-295, 2003

      15 Kirkaldy-Willis WH, "Lumbar spinal nerve lateral entrapment" (169) : 171-178, 1982

      16 Hasegawa T, "Lumbar foraminal stenosis: critical heights of the intervertebral discs and foramina. A cryomicrotome study in cadavera" 77 : 32-38, 1995

      17 Lee CK, "Lateral lumbar spinal canal stenosis: classification, pathologic anatomy and surgical decompression" 13 : 313-320, 1988

      18 Zwaan L, "Is bias in the eye of the beholder? A vignette study to assess recognition of cognitive biases in clinical case workups" 26 : 104-110, 2017

      19 Tafazal SI, "Incidental durotomy in lumbar spine surgery : incidence and management" 14 : 287-290, 2005

      20 Lewandrowski KU, "Incidence, management, and cost of complications after transforaminal endoscopic decompression surgery for lumbar foraminal and lateral recess stenosis : a value proposition for outpatient ambulatory surgery" 13 : 53-67, 2019

      21 Schizas C, "Incidence and management of pulmonary embolism following spinal surgery occurring while under chemical thromboprophylaxis" 17 : 970-974, 2008

      22 Yeung AT, "In-vivo endoscopic visualization of pathoanatomy in symptomatic degenerative conditions of the lumbar spine II : intradiscal, foraminal, and central canal decompression" 21 : 299-319, 2011

      23 Yeung AT, "In-vivo endoscopic visualization of pain generators in the lumbar spine" 6 : 385-, 2017

      24 Henriksen K, "Hindsight bias, outcome knowledge and adaptive learning" 12 (12): ii46-ii50, 2003

      25 Hugh TB, "Hindsight bias in medicolegal expert reports" 176 : 277-278, 2002

      26 Botwin KP, "Fluoroscopically guided lumbar transformational epidural steroid injections in degenerative lumbar stenosis : an outcome study" 81 : 898-905, 2002

      27 Yeung A., "Failed back surgery syndrome: endoscopic documentation of common causes by visualization of painful patho-anatomy in the hidden zone of the axilla containing the dorsal root ganglion and salvage treatment of neuropathic pain with DRG neuromodulation [abstract]" 2017

      28 el-Khoury GY, "Epidural steroid injection : a procedure ideally performed with fluoroscopic control" 168 : 554-557, 1988

      29 Yeung A, "Endoscopic identification and treating the pain generators in the lumbar spine that escape detection by traditional imaging studies" 6 : 369-, 2017

      30 Yeung AT, "Endoscopic decompression, foraminal-plasty and dorsal rhizotomy for foraminal stenosis and lumbar spondylosis : a hybrid procedure in lieu of fusion" 4 : 322-, 2016

      31 Bakeman R, "Detecting sequential patterns and determining their reliability with fallible observers" 2 : 357-370, 1997

      32 Wübken M, "Dealing with diagnostic uncertainty in general practice" 107 : 632-637, 2013

      33 Ramirez LF, "Complications and demographic characteristics of patients undergoing lumbar discectomy in community hospitals" 25 : 226-230, 1989

      34 Kraemer R, "Classification and management of early complications in open lumbar microdiscectomy" 12 : 239-246, 2003

      35 Huskisson EC, "Application of visual-analogue scales to the measurement of functional capacity" 15 : 185-187, 1976

      36 Hernandez-Perez PA, "Analysis of the lumbar discectomy complications" 16 : 419-426, 2005

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      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 0.13 0.13 0.14
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
      0.13 0.12 0.411 0
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