Percutaneous endoscopic decompression of the central degenerative stenoses of the lumbosacral spine

   Background. Degenerative stenosis of the spinal canal is a condition observed mostly in the elderly. It significantly decreases their quality of life and physical activity. Surgical treatment of the patients is frequently associated with significant surgical and anesthesiologic risks especially during conventional open decompression. The problem of decreasing invasiveness of surgical interventions is important for these patients because in their case lighter postoperative injury and decreased recovery duration after surgery are crucial.

   Aim. To evaluate clinical outcomes in patients with central degenerative lumbosacral stenoses after percutaneous endoscopic decompression.

   Materials and methods. Comparison of clinical and radiological characteristics before surgery, on day 1 and month 6 after surgery was performed. Among clinical characteristics, pain syndrome in the leg / legs per the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were evaluated. The evaluated radiological characteristic was the spinal canal cross-sectional area (CSA) in cm2 per the magnetic resonance imaging. Statistical analysis was performed using the SPSS Statistics v. 26.0 (IBM, USA) software.

   Results. Pain syndrome in the leg / legs (decreased VAS score) after surgery decreased significantly (р = 0.006). No significant difference between the VAS scores on day 1 and 6 months after the surgery was found (adjusted significance level padj = 1.000). Similarly, disability index changes were statistically significant after surgery (р = 0.005): ODI score decreased. Additionally, no statistically significant differences between ODI score on day 1 and 6 months after surgery were observed (padj = 1.000). Increase in CSA of the spinal canal was statistically significant (р = 0.001), no differences in this parameter on day 1 and 6 months after surgery were found. Conversion to microsurgical access was necessary in 4 (23.5 %) of 17 patients. No statistically significant differences in VAS, ODI scores and CSA changes at different time points were observed in patients who required conversion.

   Conclusion. Results of the study show significant improvement of the patients’ clinical status (per the VAS and ODI) and achievement of adequate radiological decompression (increased spinal canal CSA) which persisted for 6 months after percutaneous endoscopic interventions.

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