PMID- 29794584
OWN - NLM
STAT- MEDLINE
DCOM- 20190610
LR  - 20220330
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 43
IP  - 24
DP  - 2018 Dec 15
TI  - Efficacy and Safety of Full-endoscopic Decompression via Interlaminar Approach 
      for Central or Lateral Recess Spinal Stenosis of the Lumbar Spine: A 
      Meta-analysis.
PG  - 1756-1764
LID - 10.1097/BRS.0000000000002708 [doi]
AB  - STUDY DESIGN: A meta-analysis of five retrospective cohort studies. OBJECTIVE: 
      The aim of the study was to delineate the efficacy and safety of full-endoscopic 
      decompression via the interlaminar approach for central or lateral recess spinal 
      stenosis of the lumbar spine using a meta-analysis. SUMMARY OF BACKGROUND DATA: 
      The paradigm of spinal endoscopy is shifting from treatment of soft disc 
      herniation to that of lumbar spinal stenosis. Technical advancements have enabled 
      full-endoscopic decompression in spinal stenosis surgery. There is few strong 
      evidence supporting this surgical technique, and clinicians usually rely on their 
      own opinions and experiences. METHODS: A systematic search of electronic 
      databases, including PubMed, EMBASE, Cochrane Library, Web of science, and 
      KoreaMed, up to August 2017 was performed to identify studies concerning 
      full-endoscopic decompression via the interlaminar approach for lumbar spinal 
      stenosis. Changes in clinical outcomes [Oswestry Disability Index (ODI) and 
      Visual Analog Scales (VAS) for back and leg pain] were compared with the minimal 
      clinically important difference (MCID) for each item. We then calculated the mean 
      differences and 95% confidence intervals (95% CIs) using random-effects models. 
      RESULTS: We included data from five studies involving 156 patients at 6- and 
      12-month follow-ups. The majority of enrolled papers included patients with 
      neurogenic claudication due to central stenosis refractory to conservative 
      management and excluded patients with significant instability or previous 
      surgery. The overall mean difference of patients with ODI and VAS scores for leg 
      and back pain exceeded the criteria for MCID. ODI scores improved by 41.71 (95% 
      CI, 39.80-43.62) after the surgery, which was twice the MCID. The VAS leg and 
      back pain scores improved by 5.95 (95% CI, 5.70-6.21) and 4.22 (95% CI, 
      3.88-4.56), respectively, indicating statistically significant improvement over 
      the MCID. CONCLUSION: Successful clinical outcomes can be achieved with 
      full-endoscopic decompression via the interlaminar approach for lumbar central 
      spinal stenosis in patients for the defined indications. LEVEL OF EVIDENCE: 2.
FAU - Lee, Chang-Hyun
AU  - Lee CH
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul, the 
      Republic of Korea.
FAU - Choi, Miyoung
AU  - Choi M
AD  - National Evidence Based Healthcare Collaborating Agency (NECA), Seoul, the 
      Republic of Korea.
FAU - Ryu, Dal Sung
AU  - Ryu DS
AD  - Department of Neurosurgery, Inha University Hospital, College of Medicine, Inha 
      University, Incheon, the Republic of Korea.
FAU - Choi, Il
AU  - Choi I
AD  - Department of Neurological Surgery, Dongtan Sacred Heart Hospital, University of 
      Hallym University, Hwaseong, the Republic of Korea.
FAU - Kim, Chi Heon
AU  - Kim CH
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul, the 
      Republic of Korea.
AD  - Department of Neurosurgery, Seoul National University College of Medicine, Seoul, 
      the Republic of Korea.
AD  - Neuroscience Research Institute, Seoul National University Medical Research 
      Center, Seoul, the Republic of Korea.
AD  - Clinical Research Institute, Seoul National University Hospital, Seoul, the 
      Republic of Korea.
FAU - Kim, Hyeun Sung
AU  - Kim HS
AD  - Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, the Republic of 
      Korea.
FAU - Sohn, Moon-Jun
AU  - Sohn MJ
AD  - Department of Neurosurgery, Ilsan Paik Hospital, Inje University College of 
      Medicine.
AD  - Neuroscience & Radiosurgery Hybrid Research Center, Inje University College of 
      Medicine, Goyang, the Republic of Korea.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
EIN - Spine (Phila Pa 1976). 2019 Feb 15;44(4):E258. PMID: 30720665
MH  - Back Pain/surgery
MH  - Decompression, Surgical/adverse effects/*methods
MH  - Disability Evaluation
MH  - *Endoscopy/adverse effects
MH  - Humans
MH  - Lumbar Vertebrae/surgery
MH  - Minimal Clinically Important Difference
MH  - Pain Measurement
MH  - Spinal Stenosis/*surgery
MH  - Treatment Outcome
EDAT- 2018/05/26 06:00
MHDA- 2019/06/14 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2019/06/14 06:00 [medline]
PHST- 2018/05/26 06:00 [entrez]
AID - 00007632-201812150-00017 [pii]
AID - 10.1097/BRS.0000000000002708 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2018 Dec 15;43(24):1756-1764. doi: 
      10.1097/BRS.0000000000002708.