Minimally invasive endoscopic bilateral decompression with a unilateral approach (endo-BiDUA) for elderly patients with lumbar spinal canal stenosis.
OBJECTIVE
Endoscopic spinal surgery has become increasingly common year for year because it is a minimally invasive procedure. In our hospital, we introduced endoscopic bilateral decompression with a unilateral approach (endo-BiDUA) in 2006. In this paper, we review clinically and radiographically the elderly patients who underwent the endo-BiDUA.


METHODS
Fifteen patients aged over 65 years were included in this review. They had undergone endo-BiDUA between January 2006 and July 2008. Operation time, blood loss, complications, clinical outcome using the Japanese Orthopedic Association (JOA) score, and enlargement ratio of the dural tube on magnetic resonance imaging (MRI), were evaluated.


RESULTS
The mean operation time per level of endo-BiDUA was 144 min. Blood loss was about 60.2 mL. One patient had a post-surgical hematoma and required an additional laminectomy and removal of the hematoma 2 days after the surgery. No other complications such as dural tear, nerve root injury, or infection were encountered. All patients but one, who had a post-surgical hematoma, could start walking within 2 days following the surgery. Before surgery, the mean JOA score was 17.0 and it improved to about 23.3 after the surgery. The area of the dural tube increased to 408.0% after the surgery (range: 211-774%).


CONCLUSIONS
Endo-BiDUA facilitated the return of elderly patients with lumbar spinal canal stenosis to their original daily activities.
Department of Orthopedic Surgery, Tokushima University Hospital, Tokushima, Japan.
K
K
Wada
K
K
Sairyo
T
T
Sakai
N
N
Yasui
D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome