Single Incision Tubular Decompression to Treat Multi-level Lumbar Spinal Stenosis: A Retrospective Review

Abstract

Objective To evaluate the technical feasibility and assess the clinical outcomes of tubular decompression (TD) in cases of multilevel lumbar canal stenosis operated through a single incision. TD has established itself in the surgical management of single level lumbar stenosis. Literature on performance of TD for multilevel stenosis through a single incision are non-existent. Methods All patients undergoing TD for multilevel lumbar stenosis through a single incision from January 2007 to January 2018 were included. Patient demographics, operative and peri-operative details were documented. Patient based clinical outcomes, namely Visual Analogue Scale (VAS) scale for back and leg pain and Oswestry Disability Index (ODI) were assessed. Results Favorable tube trajectory and adequate decompression could be achieved through a single incision to decompress multiple levels. The VAS improved from mean 3±1.5 (2–5) to 2±0.8 (1–4) and 7±1.4 (4–9) to 2±1 (1–5) for back and leg pain respectively; while the ODI improved from a mean 44.6±8.6 (32–68) to 20.2±5.3 (16–42) at 3 months post-op and was maintained at 1±0.8 (1–4), 1.6±0.67 (1–3) and 19±2.9 (16–26) respectively at 2 years follow-up. Conclusion TD for multilevel stenosis done through a single incision is a feasible option with good to excellent results.

Keywords

• multi-level lumbar spinal stenosis
• micro-lumbar decompression
• lumbar canal stenosis
• neurogenic claudication
• tubular decompression
• micro-endoscopic decompression