A Retrospective Review of Full-Endoscopic Assisted Lumbar Decompression in an Outpatient, Ambulatory Facility

5-Year Study on Complications and Risk Factors of Minimally Invasive Surgery

BOTHELL, WA, March 14, 2017 /24-7PressRelease/ -- Dr. Kamson of the Spine Institute Northwest, an outpatient facility specializing in minimally invasive (MIS) back surgery, presented a review of a 5-year study on the results of procedures performed on 178 patients from 2011 to 2015. The review, available online at www.painphysicianjournal.com, was co-authored with Dr. Andrea Trescot of the Pain and Headache Center, Wasilla, AK, Paul D. Sampson, PhD, of the University of Washington Department of Statistics, and Yiyi Zhang, BS.

Back pain caused by lumbar spinal stenosis (narrowing of the spaces or canal in the spine) becomes increasingly common in an aging population as natural degeneration of their spines occur. With degeneration of the spine, back and leg pains manifest due to the presence of bulging discs, thickening of the ligamentum flavum (ligaments of the spine that connect the layers of the vertebrae), the formation of osteophytes (bone spurs along the joints), or the development of synovial cysts along the spine.

Conventional treatment for spinal stenosis involves a laminectomy (removal of the lamina or part of the vertebrae covering of the spinal canal), also referred to as spinal decompression surgery. There are many drawbacks with traditional open back surgery, however. These include the need for larger incisions, high blood loss, epidural scarring, extended convalescence, and the need for longer inpatient hospital stays.

In this study, a comparison was made of outcomes of free-standing, outpatient ambulatory procedures for full-endoscopic assisted MIS lumbar decompression with other spine surgery techniques. The 178 patients, whose ages ranged from 16 to 90 years old, suffered from various back problems and underwent lumbar decompressive surgery through interlaminal and foraminal full-endoscopic assisted methods.

Most of the patients considered in this study had lumbar degenerative disc disease (97%), facet arthropathy (82%), foraminal stenosis (72%) and central canal stenosis (57%). Criteria for comparing MIS with other spine surgery techniques included OR (operative time), complication rates, estimated blood loss, both preoperative and postoperative leg and back VAS scores (visual analogue scale for measuring subjective pain) and patient satisfaction. Of the 178 patients operated on, there were 3 complications which necessitated follow-up operations. These all involved postoperative reherniations. Minor complications included 2 instances of sympathetically mediated pain syndrome and a single case of postanesthetic transient urinary retention.

In the review of related literature, overall complications were much higher for traditional open lumbar disc surgery (5.3% to 20.7%) while overall complications for microendoscopic discectomy (MED) were between 4.0 to 41.5%. Overall complication rates for minimally invasive surgery vary from 5% to 15.4% while studies on full-endoscopic assisted lumbar discectomy are reportedly at 16.6% overall.

The study showed that OR is significantly influenced by factors such as age, while body-mass index does not have any significant effect on OR time. Patients who were heavier did not have longer OR times when compared to patients who were lighter in weight.

Majority of patients (95%) experienced less than 5 mL of blood loss during their procedures. VAS scores went from 7 to 3. A great number of patients (70-80%) were either greatly satisfied or satisfied with the outcomes of their surgeries and 88% would recommend it, showing that MIS is a safe and viable alternative to traditional open back surgery.

About Spine Institute Northwest

Spine Institute Northwest has been providing quality healthcare services since 2000. The medical team at Spine Institute Northwest strives to deliver excellent medical service and care with an emphasis on minimally invasive procedures such as laser spine surgery. The Institute's philosophy places a strong emphasis on early intervention, starting with an accurate diagnosis and initiation of proper treatment. At Spine Institute Northwest, the focus is on preventing the kind of chronic disability often associated with untreated or poorly managed, intractable pain. Learn more at www.spineinstitutenorthwest.com.

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