Percutaneous Endoscopic Decompression Through Bilateral Transforaminal Approach For Lumbar Central Canal Stenosis

Endoscopic techniques have garnered positive outcomes in treating lumbar spinal stenosis, with percutaneous endoscopic transforaminal decompression showing particular efficacy for addressing stenosis in the intervertebral foramen and lateral recess. However, the use of transforaminal decompression for central lumbar spinal stenosis (CLSS) is often met with skepticism. In this section, the authors share insights from their practice alongside data from a sequential observational study involving 47 CLSS patients treated via a bilateral transforaminal endoscopic approach. Clinical metrics such as the Oswestry Disability Index (ODI), VAS scores for back and leg pain, and the Macnab criteria were employed to measure the outcomes. The radiographic analysis involved comparing the lumbar dural sac's cross-sectional area before and after the procedure. The findings indicate substantial clinical improvement and a notable expansion of the dural sac's cross-sectional area at the final follow-up. There were no reported cases of infection, wound complications, or need for subsequent surgery. Thus, barring principal pathologies located dorsally to the dural sac, the bilateral transforaminal endoscopic approach is advocated as an adequate, reliable, and minimally invasive option for CLSS management.

Keywords: Central Lumbar Spinal Stenosis, Foraminoplasty, Minimally invasive treatment, Percutaneous endoscopic lumbar decompression.