Surgical procedures and clinical results of endoscopic decompression for lumbar canal stenosis

The purpose of this study was to evaluate the surgical indication and clinical outcomes of endoscopic decompression for lumbar spinal canal stenosis. From September 1998 to March 2002, 250 consecutive patients underwent posterior endoscopic surgery for lumbar radiculopathy. Among these patients, 27 were treated by posterior endoscopic decompression for lumbar canal stenosis. There were 19 men and 8 women, and their average age was 60 +/- 12.8 years. The major preoperative symptom was neurologic claudication, sometimes accompanied by sciatica. Clinical outcomes were evaluated by the Japanese Orthopedic Association (JOA) scoring system for lumbar disease (maximum score, 29). Among the 27 patients, the average JOA score was 13.7 +/- 3.8 preoperatively, which improved to 26.4 +/- 2.8 postoperatively. The average operation time was 56 min for one level, and the average blood loss was 46 ml for one level. There were no interoperative complications. The microendoscopic decompression technique is characterized by a small skin incision, less invasion of paraspinal muscle, and a small dead space. The ipisilateral approach and contralateral endoscopic decompression can be performed under the midline posterior structures the same as microsurgical decompression. This endoscopical decompression minimizes resection of the pathologic compression tissues and affords a safe procedure. The clinical outcome was excellent and patient satisfaction was good in most cases.