Percutaneous Full-Endoscopic Lumbar Foraminoplasty and Decompression by using a Visualization-reamer for Elderly Lumbar Lateral Recess and Foraminal Stenosis

Abstract Background Percutaneous endoscopic lumbar discectomy (PELD) has been widely used to treat various types of lumbar disc herniation, it has the advantages of less trauma, faster recovery, lower costs and higher percentage of patient satisfaction compared with open surgery. However, the treatment of lumbar spinal stenosis (LSS) is still regarded as a challenging task for percutaneous full-endoscopic surgery, especially for the elderly with multiple comorbidities and complex pathological factors. Objective To introduce a technique of percutaneous full-endoscopic lumbar foraminoplasty and decompression (PFELFD) by using a visualization-reamer for treating elderly lateral recess and foraminal stenosis and evaluate its efficacy and safety. Methods A retrospective review was conducted on 65 consecutive elderly patients (30 males and 35 females) with lateral recess and foraminal stenosis who underwent PFELFD from January 2017 to September 2017. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were used for the evaluation of pain relief and neurological improvement. Results The mean age was 71.58 years (range 65-89 years). The mean follow-up period was 16.12 months (range, 12-20 months). The mean operative time was 98.59 min per level (range, 55-120 min). The mean intraoperative perspective frequency was 3.21 times (range, 2-6 times). The mean hospital stay after the procedure was 2.18 days (range, 1-4 days). The back and leg VAS, ODI all over the time-points in the postoperative period were significantly lower than preoperative (P Conclusions PFELFD using a visualization-reamer is an effective and safe treatment for elderly lumbar lateral recess and foraminal stenosis. It improves the safety and efficiency of decompression and reduces intraoperative fluoroscopy.