title: Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study.
abstract: BACKGROUND
  Extensive decompression with laminectomy, where appropriate, is often still described as the method of choice when operating on degenerative lumbar spinal stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the surgical advantages they offer and the benefits for rehabilitation. One key issue when operating on the spine was the development of instruments to provide sufficient bone resection under continuous visual control. This was achieved by using endoscopes for operations carried out in cases of spinal canal stenosis.
  
  
  OBJECTIVE
  This study of patients with degenerative lumbar central spinal stenosis compares the results of spinal decompression using the full-endoscopic interlaminar technique (FI) with a conventional microsurgical laminotomy technique (MI).
  
  
  METHODS
  Prospective, randomized, controlled study.
  
  
  METHODS
  135 patients with microsurgical or full-endoscopic decompression were followed up for 2 years. Alongside general and specific parameters, the following measuring instruments were also used for the investigation: Visual Analog Scale (VAS), German version of the North American Spine Society Instrument (NASS), Oswestry Low-Back-Pain-Disability Questionnaire (ODI).
  
  
  RESULTS
  Postoperatively 72 % of the patients no longer had leg pain or the pain was almost completely reduced and 21.2 % experienced occasional pain. The clinical results were the same in both groups. The rate of complications and revisions was significantly reduced in the FI Group. The full-endoscopic techniques brought advantages in the following areas: operation, complications, traumatization, rehabilitation.
  
  
  CONCLUSIONS
  Lack of placebo control group.
  
  
  CONCLUSIONS
  The recorded results demonstrate that the full-endoscopic interlaminar bilateral decompression adopting a unilateral approach provides an adequate and safe supplement and alternative to the conventional microsurgical bilateral laminotomy technique when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.
authors: Center for Spine Surgery and Pain Therapy, Germany.
authors: Martin
authors: M
authors: Komp
authors: Patrick
authors: P
authors: Hahn
authors: Semih
authors: S
authors: Oezdemir
authors: Athanasios
authors: A
authors: Giannakopoulos
authors: Roderich
authors: R
authors: Heikenfeld
authors: Richard
authors: R
authors: Kasch
authors: Harry
authors: H
authors: Merk
authors: Georgios
authors: G
authors: Godolias
authors: Sebastian
authors: S
authors: Ruetten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D007866:Leg; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D010146:Pain / Q000601:surgery; D010147:Pain Measurement; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome