Skip to content
2000
image of Ambulatory Uniportal Interlaminar Endoscopic Approach for Symptomatic Adjacent Segment Disease after Lumbar Fusion in Aged Patients

Abstract

Introduction

There is no consensus on treating symptomatic adjacent segment disease (ASD). The best choice depends on several factors. Spinal fusion is associated with complications that may be more relevant in adult patients. The study aimed to report the feasibility and clinical results obtained in patients over 60 years of age with ASD treated with a uniportal interlaminar endoscopic approach.

Materials and Methods

We retrospectively reviewed patients> 60 years old admitted with radicular symptoms secondary to ASD history between May 2020 and January 2023 who underwent endoscopic surgery using a uniportal interlaminar approach. We collected information on patient-reported outcome measures (PROMs), including pre-and postoperative visual analog scale index (VAS), Oswestry ODI criteria, and patient satisfaction score using the MacNab criteria.

Results and Discussion

Eight patients, five women and three men, with an average age of 72.8 ± 7.89 years, were included in the study. The average follow-up time was 23.0 ± 16.7 months. The difference between the preoperative and postoperative VAS and ODI was statistically significant. Satisfaction with the procedure was above 80%, and the results were excellent. There were no intraoperative complications; only one case had to be reoperated with a conventional technique. No patient had a hospital stay.

Conclusion

Ambulatory uniportal interlaminar endoscopic surgery is a technique that may become an alternative for the treatment of symptomatic ASD in patients over 65 years of age.

Loading

Article metrics loading...

/content/journals/cse/10.2174/0129497795283901250130115849
2025-02-06
2025-12-15
Loading full text...

Full text loading...

References

  1. Wang N. Xie Y. Liu X. Zheng Y. Xi Z. Xu W. Deng R. Tang T. Liu X. Safety and clinical efficacy of endoscopic procedures for the treatment of adjacent segmental disease after lumbar fusion: A systematic review and meta-analysis. PLoS One 2023 18 2 e0280135 10.1371/journal.pone.0280135 36745653
    [Google Scholar]
  2. Nourbakhsh A. Burch M.B. Wiegers N.W. Patil S. Incidence and risk factors of reoperation in patients with adjacent segment disease: A meta-analysis. J. Craniovertebr. Junction Spine 2020 11 1 9 16 10.4103/jcvjs.JCVJS_10_20 32549706
    [Google Scholar]
  3. Donnally C.J. Patel P.D. Canseco J.A. Divi S.N. Goz V. Sherman M.B. Shenoy K. Markowitz M. Rihn J.A. Vaccaro A.R. Current incidence of adjacent segment pathology following lumbar fusion versus motion-preserving procedures: a systematic review and meta-analysis of recent projections. Spine J. 2020 20 10 1554 1565 10.1016/j.spinee.2020.05.100 32445805
    [Google Scholar]
  4. Azadi A. Arjmand N. A comprehensive approach for the validation of lumbar spine finite element models investigating post-fusion adjacent segment effects. J. Biomech. 2021 121 110430 10.1016/j.jbiomech.2021.110430 33873115
    [Google Scholar]
  5. Feng P. Kong Q. Zhang B. Liu J. Ma J. Hu Y. Percutaneous full endoscopic lumbar discectomy for symptomatic adjacent segment disease after lumbar fusion in elderly patients. Orthop. Surg. 2023 15 7 1749 1755 10.1111/os.13725 37232005
    [Google Scholar]
  6. Drysch A. Ajiboye R.M. Sharma A. Li J. Reza T. Harley D. Park D.Y. Pourtaheri S. Effectiveness of reoperations for adjacent segment disease following lumbar spinal fusion. Orthopedics 2018 41 2 e161 e167 10.3928/01477447‑20170621‑02 28662247
    [Google Scholar]
  7. Hashimoto K. Aizawa T. Kanno H. Itoi E. Adjacent segment degeneration after fusion spinal surgery—a systematic review. Int. Orthop. 2019 43 4 987 993 10.1007/s00264‑018‑4241‑z 30470865
    [Google Scholar]
  8. Martin B.I. Mirza S.K. Spina N. Spiker W.R. Lawrence B. Brodke D.S. Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the united states, 2004 to 2015. Spine 2019 44 5 369 376 10.1097/BRS.0000000000002822 30074971
    [Google Scholar]
  9. Han H. Song Y. Li Y. Zhou H. Fu Y. Li J. Short-term clinical efficacy and safety of unilateral biportal endoscopic transforaminal lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a systematic review and meta-analysis. J. Orthop. Surg. Res. 2023 18 1 656 10.1186/s13018‑023‑04138‑0 37667363
    [Google Scholar]
  10. Yang C.C. Chen C.M. Lin M.H.C. Huang W.C. Lee M.H. Kim J.S. Chen K.T. Complications of full-endoscopic lumbar discectomy versus open lumbar microdiscectomy: a systematic review and meta-analysis. World Neurosurg. 2022 168 333 348 10.1016/j.wneu.2022.06.023 36527213
    [Google Scholar]
  11. Giordan E. Radaelli R. Gallinaro P. Pastorello G. Zanata R. Canova G. Marton E. Del Verme J. Bibliographic study and meta-analysis of clinical outcomes of full-endoscopic spine surgery for painful lumbar spine conditions. World Neurosurg. 2023 171 e64 e82 10.1016/j.wneu.2022.11.083 36442782
    [Google Scholar]
  12. Hu Z.X. Han J. Sun Y.F. Tian X.L. Comparison of percutaneous endoscopic lumbar discectomy vs. minimally invasive transforaminal lumbar interbody fusion for the treatment of single-segment lumbar disc herniation: a meta-analysis. Eur. Rev. Med. Pharmacol. Sci. 2022 26 18 6678 6690 10.26355/eurrev_202209_29769 36196718
    [Google Scholar]
  13. Ruetten S. Komp M. Merk H. Godolias G. Use of newly developed instruments and endoscopes: full-endoscopic resection of lumbar disc herniations via the interlaminar and lateral transforaminal approach. J. Neurosurg. Spine 2007 6 6 521 530 10.3171/spi.2007.6.6.2 17561740
    [Google Scholar]
  14. Hofstetter C.P. Ahn Y. Choi G. Gibson J.N.A. Ruetten S. Zhou Y. Li Z.Z. Siepe C.J. Wagner R. Lee J.H. Sairyo K. Choi K.C. Chen C.M. Telfeian A.E. Zhang X. Banhot A. Lokhande P.V. Prada N. Shen J. Cortinas F.C. Brooks N.P. Van Daele P. Kotheeranurak V. Hasan S. Keorochana G. Assous M. Härtl R. Kim J.S. AOSpine consensus paper on nomenclature for working-channel endoscopic spinal procedures. Global Spine J. 2020 10 2 Suppl. 111S 121S 10.1177/2192568219887364 32528794
    [Google Scholar]
  15. Flores-Milan G. Cuello C.C. Pressman E. Marek J. Krafft P.R. McBride P. Gassie K. Hayman E. Alikhani P. Risk factors for adjacent segment disease in short segment lumbar interbody fusion-a case series. Oper. Neurosurg. 2023 25 2 136 141 10.1227/ons.0000000000000743 37163706
    [Google Scholar]
  16. Huang T.C. E-Posters. Global Spine J. 2018 8 S1 174S 374S 10.1177/2192568218771072
    [Google Scholar]
  17. Gu G. Wang C. Gu X. Zhang H. Zhao Y. He S. Percutaneous transforaminal endoscopic discectomy for adjacent segment disease after lumbar fusion in elderly patients over 65 years old. World Neurosurg. 2018 112 e830 e836 10.1016/j.wneu.2018.01.170 29408425
    [Google Scholar]
  18. Telfeian A.E. Sastry R. Ali R. Oyelese A. Fridley J. Camara-Quintana J.Q. Niu T. Lewandrowski K.U. Gokaslan Z.L. Awake, transforaminal endoscopic lumbar decompression surgery to treat l5-s1 adjacent segment disease: A case series. Pain Physician 2022 25 4 E649 E656 35793189
    [Google Scholar]
  19. Li T. Zhu B. Liu X. Revision strategy of symptomatic lumbar adjacent segment degeneration: Full endoscopic decompression versus extended posterior interbody fusion. World Neurosurg. 2020 142 e215 e222 10.1016/j.wneu.2020.06.168 32599194
    [Google Scholar]
  20. Chen J. Jing X. Li C. Jiang Y. Cheng S. Ma J. Percutaneous endoscopic lumbar discectomy for l5s1 lumbar disc herniation using a transforaminal approach versus an interlaminar approach: A systematic review and meta-analysis. World Neurosurg. 2018 116 412 420 10.1016/j.wneu.2018.05.075 29783008
    [Google Scholar]
/content/journals/cse/10.2174/0129497795283901250130115849
Loading
/content/journals/cse/10.2174/0129497795283901250130115849
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test