Foraminal Stenosis
Conditions
Keywords
Lumbar Foraminal Stenosis, endoscopic decompression surgery, Endoscopic Foraminotomy Surgery, TLIF in lumbar foraminal stenosis, stable lumbar foraminal stenosis
Brief summary
Comparative Outcomes of Conventional Transforaminal Lumbar Interbody Fusion With Posterior Decompression Surgery Versus Endoscopic Foraminotomy Surgery in Stable Lumbar Foraminal Stenosis An Ambi-directional Cohort Study
Detailed description
Backgrounds : Lumbar foraminal stenosis is a condition in which a spinal nerve is entrapped in a narrow lumbar foramen in degenerative lumbar spinal disorders. The gold standard treatment of this condition has not been proposed yet. Several different techniques for this problem has been described, including foraminotomy, facetectomy, partial pediculectomy, fusion, and distraction instrumentation.Nowadays, due to the great advancement of the technology in endoscopy expanded the indication of endoscopic decompression from the central canal to the extraforaminal zone, Which was difficult to gain access from the mere microscope. Objectives : To compare outcomes between posterior decompression With conventional transforaminal lumbar interbody fusion (TLIF) and full-endoscopic foraminoplasty (FELF) in stable lumbar foraminal Stenosis Methods : This is an ambi-directional cohort study, In retrospective part conducted from JAN2019-JAN2024 in Queen Savang Vadhana Memorial Hospital and the prospective part conducted from AUG2024 - JUNE 2025, Thailand. 60 patients presented with stable lumbar foraminal stenosis were divided into posterior decompression with conventional transforaminal lumbar interbody fusion (TLIF) group ( N=30) and full-endoscopic lumbar foraminoplasty (FELF) group (N=30). Demographic data and pre-perioperative parameters were analyzed. For TLIF group , Standard procedure had been performed. Posterior decompression, pedicle screws and interbody cage ( Mont blanc, Spineway, France) insertion under image intensifier ( BV Pulsera,Philips).For endoscopic foraminoplasty , uniportal stenoscope ( Vertebris ,Riwospine ) was used to perform endoscopic decompressive surgery. Post-operative outcome , for instance , Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) were recorded at preoperative, post-op day1, 3 month, 6 month and 1 year respectively. Other parameters such as estimated blood loss (EBL), length of hospital stay and post- operative complications were also recorded
Interventions
PROCEDUREEndoscopic Foraminotomy Surgery
Endoscopic Foraminotomy Surgery in Stable Lumbar Foraminal Stenosis
Sponsors
Queen Savang Vadhana Memorial Hospital, Thailand
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Comparative Outcomes of Conventional Transforaminal Lumbar Interbody Fusion With Posterior Decompression Surgery Versus Endoscopic Foraminotomy Surgery in Stable Lumbar Foraminal Stenosis An Ambi-directional Cohort Study
Eligibility
Sex/Gender
ALL
Age
30 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age 30-80 * Persist radiculopathy and sciatica pain * Patient that was diagnosed Stable lumbar foraminal stenosis * Failed conservative for at least 6 months * Patients who willing to join the study
Exclusion criteria
* Patients with unstable lumbar foraminal stenosis * Patient with spine infection or tumor or fracture * Patient with BMD less than -2.5 or osteopenia * Patient with inflammatory joint diseases who on steroids * Patient who has undergo with surgery that inserted metals in back * Unable to answer questionnaires * Cannot tolerate surgery due to severe medical comorbidities
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oswestry disability index (ODI) score post-operation at 12months | 12 months | Oswestry disability index (ODI) questionnaire at 12 months postoperative. The final score/index ranges from 0-100. A score of 0-20 reflects minimal disability, 21-40 moderate disability, 41-60 severe disability, 61-80 crippled, and 81-100 bed-bound. Minimal clinical difference has been evaluated across numerous types of spinal surgery, and has been shown to vary significantly. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| visual analog scale (VAS) of pain both leg and back | 1day, 2 weeks, 6weeks, 3 months, 6 months and 12 months | visual analog scale (VAS) of pain.A Visual Analogue Scale (VAS) score is interpreted by measuring the distance from the no pain end of a 100-mm line to a mark made by the patient to indicate their pain level. A higher score indicates greater pain intensity. |
| estimated blood loss (EBL) | perioperation | intraoperative estimated blood loss (EBL) measure in milliliter. estimated blood loss is a reliable predictor of actual blood loss during orthopedic procedures. |
| operative time | perioperation | operative time measure in minutes, usually 60-90 minutes |
| Oswestry disability index (ODI) score post-operation at 6week, 3 months and 6 months | 6week, 3 months and 6 months | Oswestry disability index (ODI) questionnaire at 6week, 3 months and 6 months. The final score/index ranges from 0-100. A score of 0-20 reflects minimal disability, 21-40 moderate disability, 41-60 severe disability, 61-80 crippled, and 81-100 bed-bound. Minimal clinical difference has been evaluated across numerous types of spinal surgery, and has been shown to vary significantly |
| time return to work | through the study completion, an average of 1 year | time return to work |
| postoperative complications | through the study completion, an average of 1 year | postoperative complications |
| length of hospital stay | from 3 days to 1 week | length of hospital stay |
Countries
Thailand
Outcome results
None listed