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Clinical and radiological outcomes of endoscopic foraminoplasty and decompression assisted with preoperative planning software for lumbar foraminal stenosis

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Abstract

Purpose

To assess the clinical and radiological outcomes of using endoscopic foraminoplasty and decompression assisted with a preoperative planning software in the treatment of lumbar foraminal stenosis.

Methods

This retrospective study included 43 patients with lumbar foraminal stenosis (Jan 2018 and June 2019). These patients were divided into two groups. Patients in the conventional group (group A) underwent endoscopic lumbar foraminoplasty and decompression. Patients in the experimental group (group B) underwent the same surgery assisted with a preoperative software. The total operation time, puncture-channel establishment time, and the number of intraoperative fluoroscopic images taken were recorded. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were administered preoperatively and postoperatively (at 1-month, 3-month, and 12-month follow-up). The modified MacNab criteria were used to assess the global outcome at 12-month follow-up.

Results

Patients in group B had shorter operation time, puncture-channel establishment time, and less number of intraoperative fluoroscopic images taken, as compared with group A. The VAS and ODI scores were significantly lower than pre-operation for both groups at all follow-ups. No significant difference was observed between these two groups. Based on the modified MacNab criteria, the excellent-to-good rate was 86.4% in group A and 90.5% in group B, respectively. After the operation, no patients had residual osteophytes in group B, while two patients still had residual osteophytes and foraminal stenosis in group A.

Conclusion

For endoscopic surgery treating lumbar foraminal stenosis, using preoperative planning software could reduce the puncture-channel establishment time, operation time, and the number of intraoperative fluoroscopic images taken without affecting the clinical outcomes.

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Acknowledgements

The authors would like to thank Dr. Bingqian Zhu, from Shanghai Jiao Tong University School of Nursing, for the editorial assistance.

Funding

This work was supported by grants from the National Natural Science Foundation of China (to C. Shi, No. 81802120), Shanghai Sailing Program (to C. Shi, No.18YF1423100), Clinical project of Shanghai Health and Family Planning Commission (to C. Shi, No.20204Y0243), and “Pyramid talent project” of Shanghai Changzheng Hospital.

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Author notes

  1. Changgui Shi and Bin Sun contributed equally to this work and should be considered as co-first authors.

Authors and Affiliations

  1. Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, People’s Republic of China

    Changgui Shi, Bin Sun, Guoke Tang, Ning Xu, Hailong He, Xiaojian Ye, Guohua Xu & Xin Gu

  2. Department of Orthopedic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

    Guoke Tang & Xiaojian Ye

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  1. Changgui Shi
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Contributions

XG and GX designed the study. CS and BS followed up the patients, analyzed CT imaging data, and wrote the first draft of the manuscript. GT and NX retrieved the data. HH and XY were responsible for statistical analysis of the data. All authors revised the paper critically for intellectual content and approved the final version.

Corresponding authors

Correspondence to Guohua Xu or Xin Gu.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Availability of data and material

XG had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Ethical approval

Ethical approval was waived by the Institutional Review Board (IRB) of the Second Military Medical University in view of the retrospective nature of the study. All the procedures being performed were part of the routine care.

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For this type of study, formal consent is not required.

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Shi, C., Sun, B., Tang, G. et al. Clinical and radiological outcomes of endoscopic foraminoplasty and decompression assisted with preoperative planning software for lumbar foraminal stenosis. Int J CARS 16, 1829–1839 (2021). https://doi.org/10.1007/s11548-021-02453-7

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  • DOI: https://doi.org/10.1007/s11548-021-02453-7

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