Minimally invasive microsurgical decompression in patients with monosegmental lumbar spinal stenosis

Konovalov NA, Brinyuk ES, Kaprovoy SV, Nazarenko AG, Zakirov BA, Strunina YuV, Stepanov IA. Minimally invasive microsurgical decompression in patients with monosegmental lumbar spinal stenosis. Burdenko's Journal of Neurosurgery. 2022;86(5):66‑73. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20228605166

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze the results of minimally invasive microsurgical decompression (MI-MD) in patients with monosegmental lumbar spinal stenosis.

MATERIAL AND METHODS

A retrospective observational cohort study was performed. We analyzed medical records of patients who underwent MI-MD for monosegmental degenerative lumbar spinal stenosis. Clinical and objective results of MI-MD, as well as the types and prevalence of adverse clinical events were studied.

RESULTS

The study included 96 medical records (50 (52%) males and 46 (48%) females aged 18-84 years). Analysis of pain in lower back and lower extremities in 3, 6, 9, 12 and 24 months after MI-MD showed a significant decrease of this indicator (p<0.001). There was significant improvement of capacity according to ODI score up to 5-12% in 72.9% of patients in early postoperative period (p=0.055). In delayed postoperative period, we also observed significant improvement of working capacity according to ODI score and gradual decrease in disability index (p<0.001). Adverse clinical events occurred in 6 (6.2%) patients.

CONCLUSION

MI-MD is a highly effective surgical method for monosegmental lumbar spinal stenosis with minimal incidence of adverse clinical events.

Keywords:

lumbar spine

monosegmental spinal stenosis

minimally invasive microsurgical decompression

clinical efficacy

instrumental efficacy

adverse events

Authors:

Konovalov N.A.

Burdenko Neurosurgical Center

ORCID: 0000-0003-0824-1848

Brinyuk E.S.

Burdenko Neurosurgical Center

ORCID: 0000-0002-0346-8018

Kaprovoy S.V.

Burdenko Neurosurgical Center

ORCID: 0000-0001-8813-2793

Nazarenko A.G.

Burdenko Neurosurgical Center

ORCID: 0000-0003-1314-2887

Zakirov B.A.

Burdenko Neurosurgical Center

ORCID: 0000-0002-8782-850X

Strunina Yu.V.

Burdenko Neurosurgical Center

ORCID: 0000-0003-1696-4050

Stepanov I.A.

Irkutsk State Medical University

ORCID: 0000-0001-9039-9147

Received:

25.03.2022

Accepted:

19.08.2022

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References:

Zaina F, Tomkins-Lane C, Carragee E, Negrini S. Surgical versus non-surgical treatment for lumbar spinal stenosis. The Cochrane Database of Systematic Reviews. 2016;2016(1):CD010264. https://doi.org/10.1002/14651858.CD010264.pub2
Arabmotlagh M, Sellei RM, Vinas-Rios JM, Rauschmann M. Klassifikation und Diagnostik der lumbalen Spinalkanalstenose [Classification and diagnosis of lumbar spinal stenosis]. Orthopäde. 2019;48(10):816-823. (In German). https://doi.org/10.1007/s00132-019-03746-1
Lai MKL, Cheung PWH, Cheung JPY. A systematic review of developmental lumbar spinal stenosis. European Spine Journal. 2020;29(9):2173-2187. https://doi.org/10.1007/s00586-020-06524-2
Yang F, Wang Y, Ma Y, Hu X, Li X, Ma Z, He X, Gao Y, Yang Y, Kang X. Single-segment central lumbar spinal stenosis: Correlation with lumbar X-ray measurements. Journal of Back and Musculoskeletal Rehabilitation. 2021;34(4):581-587. https://doi.org/10.3233/BMR-200051
Palumbo MA, Lucas P, Akelman E. Lumbar spinal stenosis: A review. Rhode Island Medicine. 1995;78(11):321-323.
Siebert E, Prüss H, Klingebiel R, Failli V, Einhäupl KM, Schwab JM. Lumbar spinal stenosis: syndrome, diagnostics and treatment. Nature Reviews. Neurology. 2009;5(7):392-403. https://doi.org/10.1038/nrneurol.2009.90
Konovalov NA, Nazarenko AG, Asyutin DS, Brinyuk ES, Kaprovoy SV, Zakirov BA. Degenerative lumbar spine stenosis: minimally invasive microsurgical methods of treatment. Burdenko’s Journal of Neurosurgery. 2021;85(4):87-95. (In Russ.). https://doi.org/10.17116/neiro20218504187
Kreiner DS, Shaffer WO, Baisden JL, Gilbert TJ, Summers JT, Toton JF, Hwang SW, Mendel RC, Reitman CA. An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update). Spine Journal. 2013;13(7):734-743. https://doi.org/10.1016/j.spinee.2012.11.059
Phan K, Mobbs RJ. Minimally Invasive Versus Open Laminectomy for Lumbar Stenosis: A Systematic Review and Meta-Analysis. Spine (Phila Pa 1976). 2016;41(2):91-100. https://doi.org/10.1097/BRS.0000000000001161
Konovalov NA, Nazarenko AG, Asyutin DS, Zelenkov PV, Onoprienko RA, Korolishin VA, Cherkiev IU, Martynova MA, Zakirov BA, Timonin SYu, Kosyr’kova AV, Pimenova LF, Pogosyan AL, Batyrov AA. Modern treatments for degenerative disc diseases of the lumbosacral spine. A literature review. Burdenko’s Journal of Neurosurgery. 2016;80(4):102-108. (In Russ.). https://doi.org/10.17116/neiro2016804102-108
Von Elm E, Altman DG, Egger M, Stuart JP, Peter CG, Jan PV, STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. International Journal of Surgery. 2014;12(12):1495-1499. https://doi.org/10.1016/j.ijsu.2014.07.013
Schizas C, Theumann N, Burn A, Tansey R, Wardlaw D, Smith FW, Kulik G. Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine. 2010;35(21):1919-1924. https://doi.org/10.1097/BRS.0b013e3181d359bd
Kawabata M, Yamazaki F, Guo DW, Chatzisarantis NLD. Advancement of the Subjective Vitality Scale: examination of alternative measurement models for Japanese and Singaporeans. Scandinavian Journal of Medicine and Science in Sports. 2017;27(12):1793-1800. https://doi.org/10.1111/sms.12760
Guha D, Heary RF, Shamji MF. Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts. Neurosurgical Focus. 2015;39(4):E9. https://doi.org/10.3171/2015.7.FOCUS15259
Overdevest G, Vleggeert-Lankamp C, Jacobs W, Thomé C, Gunzburg R, Peul W. Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis. European Spine Journal. 2015;24(10):2244-2263. https://doi.org/10.1007/s00586-015-4098-4
Ghogawala Z, Dziura J, Butler WE, Dai F, Terrin N, Magge SN, Coumans JV, Harrington JF, Amin-Hanjani S, Schwartz JS, Sonntag VK, Barker FG 2nd, Benzel EC. Laminectomy plus Fusion versus Laminectomy Alone for Lumbar Spondylolisthesis. The New England Journal of Medicine. 2016;374(15):1424-1434. https://doi.org/10.1056/NEJMoa1508788
Försth P, Ólafsson G, Carlsson T, Frost A, Borgström F, Fritzell P, Öhagen P, Michaëlsson K, Sandén B. A Randomized, Controlled Trial of Fusion Surgery for Lumbar Spinal Stenosis. The New England Journal of Medicine. 2016;374(15):1413-1423. https://doi.org/10.1056/NEJMoa1513721
Schöller K, Alimi M, Cong GT, Christos P, Härtl R. Lumbar Spinal Stenosis Associated With Degenerative Lumbar Spondylolisthesis: A Systematic Review and Meta-analysis of Secondary Fusion Rates Following Open vs Minimally Invasive Decompression. Neurosurgery. 2017;80(3):355-367. https://doi.org/10.1093/neuros/nyw091
Zhang Q, Han XG, Xu YF, Fan MX, Zhao JW, Liu YJ, He D, Tian W. Robotic navigation during spine surgery. Expert Review of Medical Devices. 2020;17(1):27-32. https://doi.org/10.1080/17434440.2020.1699405
Freidberg SR, Pfeifer BA, Dempsey PK, Tarlov EC, Dube MA, Day JD, Machado DE. Intraoperative computerized tomography scanning to assess the adequacy of decompression in anterior cervical spine surgery. Journal of Neurosurgery. 2001;94(1 suppl):8-11. https://doi.org/10.3171/spi.2001.94.1.0008
Hejazi N, Witzmann A, Hassler W. Intraoperative cervical epidurography: A simple modality for assessing the adequacy of decompression during anterior cervical procedures. Technical note. Journal of Neurosurgery. 2003;98 (1 Suppl):96-99. https://doi.org/10.3171/spi.2003.98.1.0096
Alaqeel Ahmed, Abou Al-Shaar H, Alaqeel Alaa, Al-Habib A. The utility of ultrasound for surgical spinal decompression. Medical Ultrasonography. 2015;17(2):211-218. https://doi.org/10.11152/mu.2013.2066.172.spd