Journal of Pain Research (Mar 2023)

Correlation Between Postoperative Imaging Parameters and Clinical Outcomes of Percutaneous Endoscopic Transforaminal Decompression for Lumbar Spinal Foraminal and Lateral Recess Stenosis

  • Wu Q,
  • Yuan S,
  • Zang L,
  • Wang T,
  • Lu X,
  • Wang A,
  • Si F,
  • Fan N,
  • Du P

Journal volume & issue
Vol. Volume 16
pp. 1149 – 1157

Abstract

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Qichao Wu,* Shuo Yuan,* Lei Zang, Tianyi Wang, Xuanyu Lu, Aobo Wang, Fangda Si, Ning Fan, Peng Du Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lei Zang, Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China, Email [email protected]: To investigate the correlation between postoperative imaging parameters and clinical outcomes in patients with foraminal stenosis (FS) and lateral recess stenosis (LRS) who underwent percutaneous endoscopic transforaminal decompression (PETD).Methods: The study included 104 eligible patients who underwent PETD, and the mean follow-up time was 2.4 years (range 2.2– 3.6 years). Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) scores, and the modified MacNab criteria were used to evaluate the clinical outcomes. The related parameters of the FS and LRS based on computed tomography and magnetic resonance imaging were measured before and after surgery. Correlations between the imaging parameters and clinical outcomes were investigated.Results: The proportion of excellent and good results following MacNab evaluation was 82.6%. In the treatment of LRS, VAS-back, VAS-leg, and ODI at the 2-year follow-up were negatively correlated with postoperative facet joint length based on computed tomography. In the treatment of FS, the above clinical results were positively correlated with the variation of foraminal width and nerve root-facet distance before and after surgery based on magnetic resonance imaging.Conclusion: PETD can achieve good clinical outcomes in the treatment of patients with LRS or FS. Postoperative facet joint length was negatively correlated with clinical outcomes of LRS patients. In FS patients, the variation in foraminal width and nerve root-facet distance before and after surgery were positively correlated with their clinical outcomes. These findings may help surgeons optimize treatment strategies and selection of surgical candidates.Keywords: lumbar spinal stenosis, clinical outcomes, percutaneous endoscopic transforaminal decompression, microsurgery, spinal endoscopy

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