A novel technology named as selective fenestration and axial decompression for the surgical management of lumbar degenerative diseases

Abstract

Study Design: A retrospective study. Purpose: To firstly introduce a new surgical technique named as selective fenestration and axial decompression (SFAD) to improve the surgical treatment effects of lumbar degenerative diseases. Overview of literature: Posterior lumbar laminectomy and interbody fusion (LIF) is a standard surgical method for the treatment of lumbar degenerative diseases. However, its application has some limitations, and the incidence of spinal cord nerve injury is relatively high. Methods: This retrospective clinical study was conducted from January 2018 to February2020. A total of 101 eligible patients including 62 men and 39 women with lumbar disc herniation (LDH) or lumbar spinal stenosis (LSS) underwent LIF or SFAD were enrolled in this study. The average postoperative follow-up period of the LIF and SFAD groups were 20.1 ± 3.7 months and 19.7 ± 4.1 months, respectively. The clinical effects, imaging manifestation, and postoperative complications in LIF and SFAD groups were analyzed. Results: The operative time, blood loss and hospital stay in SFAD group were significantly lower than those in LIF group (P 0.05). Similarly, improvements of cobb angle of operated segment, intervertebral space height (ISH), intervertebral space foramen (IFH) and lumbar lordosis (LL) showed no statistical difference between the two groups (P > 0.05). Finally, the prevalence of complication rates in LIF group were significantly higher than the SFAD group during the follow-up period (P < 0.05) Conclusions: The application of SFAD to the surgical treatment of lumbar degenerative diseases can realize the three-dimensional and precise decompression of spinal cord nerve, which is one of the ideal alternatives to traditional LIF.

Keywords

• Lumbar spine
• LDH
• LSS
• LIF
• SFAD