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

Abstract

Objective

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

Data Sharing Statement

The raw data supporting the conclusions of this article will be made available by the corresponding author, without undue reservation.

Ethics Statement

This study was approved by the ethics committee of Beijing Chaoyang Hospital, Capital Medical University (Registration number: 2021-KE-478) and the research was performed in accordance with the guidelines of the Declaration of Helsinki. Informed consent for this study was obtained from all patients by both written and verbal.

Acknowledgments

We appreciate all the subjects who participated in the study.

Author Contributions

Conceptualization: Lei Zang and Shuo Yuan; methodology: Shuo Yuan and Qichao Wu; formal analysis and investigation: Tianyi Wang and Xuanyu Lu; writing—original draft preparation: Shuo Yuan; writing—review and editing: Shuo Yuan and Qichao Wu; funding acquisition: Lei Zang; resources: Lei Zang; supervision: Ning Fan, Wenyi Zhu, Lihui Yang, Likun An, Jian Li and Xiaochuan Kong. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.