title: Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis. Technical note.
abstract: OBJECTIVE
  The authors applied the technique of microendoscopic discectomy to posterior decompression procedures for lumbar spinal stenosis. The purpose of this study was to determine the feasibility of using an endoscopic technique to treat lumbar spinal stenosis and to evaluate the clinical and radiographic results of microendoscopic posterior decompression (MEPD).
  
  
  METHODS
  Microendoscopic posterior decompression, which involves a unilateral endoscopic approach for bilateral decompression, was performed in 47 patients. Clinical and radiographic/neuroimaging results were evaluated during the follow-up period (minimum duration 1 year). The clinical results were compared with those of the conventional laminotomy. Radiographic instability and the degree of surgical invasion of the facet joints were evaluated. In a control a group of 29 patients open laminotomy was performed. The clinical outcome was evaluated in 44 patients. The mean follow-up duration was 22 months. The mean rate of improvement was 72% based on the Japanese Orthopaedic Association score, and good results were obtained in 38 patients. Although the rate of morbidity decreased in the MEPD group, the incidence of complication was slightly higher. Effective decompression was demonstrated in the majority of the patients by using magnetic resonance imaging. Radiographic instability appeared in one patient postoperatively, and based on computerized tomography scanning, a tendency toward invasion of the facet joint on the approach side was noted.
  
  
  CONCLUSIONS
  Microendoscopic posterior decompression is a minimally invasive procedure and is as useful as other conventional procedures in treating lumbar spinal stenosis; however, a few technical problems remain to be solved.
authors.affiliation: Department of Orthopedic Surgery, Hiroshima Red Cross and Atomic-Bomb Survivors Hospital, Hiroshima, Japan. koikuta@mac.com
authors.forename: Ko
authors.initials: K
authors.lastname: Ikuta
authors.forename: Junichi
authors.initials: J
authors.lastname: Arima
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Oga
authors.forename: Soichiro
authors.initials: S
authors.lastname: Nakano
authors.forename: Kosuke
authors.initials: K
authors.lastname: Sasaki
authors.forename: Kohei
authors.initials: K
authors.lastname: Goshi
authors.forename: Masaki
authors.initials: M
authors.lastname: Yo
authors.forename: Shingo
authors.initials: S
authors.lastname: Fukagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications; D013130:Spinal Stenosis / Q000601:surgery*; D016896:Treatment Outcome