Clinical Study On The Efficacy Of Percutaneous Transforaminal Endoscopic Intervertebral Foramen Secondary Foraminoplasty In The Treatment Of Elderly Patients With Lumbar Spinal Stenosis At L5-S1

Objective: Percutaneous transforaminal endoscopic decompression(PTED)is an emerging surgical method for the treatment of lumbar spinal stenosis(LSS).In the current study,there are some difficulties in the establishment of PTED in the L5-S1 segment surgical channel.In clinical practice,it needs to be modified according to different patient conditions.For elderly patients with lumbar spinal stenosis,PTED treatment is a desirable surgical method.However,there are few clinical reports on the clinical effect of PTED in the treatment of elderly patients with lumbar spinal stenosis at L5-S1.This study retrospectively analyzed 43 elderly patients with lumbar spinal stenosis at L5-S1 who underwent percutaneous transforaminal endoscopic secondary foraminoplasty.Evaluate surgical efficacy,analyze intraoperative and postoperative complications,and summarize countermeasures.To provide a new idea and surgical method for the treatment of this type of disease in clinical work,provide surgical experience,and reduce intraoperative complications.Methods: A retrospective analysis of 46 elderly patients with lumbar spinal stenosis at L5-S1 treated with percutaneous transforaminal endoscopic secondary foraminoplasty in our department from January 2019 to May 2020 example,with a one-year follow-up.During the period,2patients died of natural causes,and 1 patient lost follow-up due to changing contact information.A total of 43 patients received complete follow-up data.Among them,17 were male patients and 26 were female patients.The average age is 71.79 years old.The visual analogue scale(VAS)and Oswestry Disability Index(ODI)were compared before and after surgery,and the modified Macnab criteria were used to evaluate the treatment effect at the last follow-up.P<0.05 was regarded as a statistically significant difference.Results: Comparison of VAS and ODI scores at various time periods after operation in 43 patients with lumbar spinal stenosis who underwent percutaneous transforaminal endoscopic secondary foraminoplasty and obtained complete follow-up data significantly reduced.The difference was statistically significant(p<0.05)The excellent and good rate at the last follow-up was 93.02%.7 patients with complications during or after operation.including 1 case of nerve root injury(2.3%);1 case of incomplete decompression(2.3%),and 1 case of unrelieved postoperative symptoms(2.3%);Symptoms recurred in 1 case(2.3%)within 1 month;cervical discomfort occurred in 2 cases(4.6%)during operation;paresthesia occurred in 2 cases(4.6%)one week after operation.Conclusions: This study shows that the clinical effect of percutaneous transforaminal endoscopic intervertebral foramen “secondary foraminoplasty” is satisfactory to the patients.However,there is still a certain incidence of complications,which are mainly related to the complex anatomical structure and the operator’s proficiency.It is necessary for the operator to take corresponding treatment methods according to the surgical experience to alleviate the symptoms of complications.