Comparison of full-endoscopic and tubular-based microscopic decompression in patients with lumbar spinal stenosis: a randomized controlled trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2024;12(7):27 Eur Spine J . 2023 Aug;32(8):2736-2747.What this means for my practice?
Overall, the results of this trial showed that FE offers a non-inferior alternative to TM for lumbar spinal stenosis, providing equivalent functional outcomes with benefits such as minimal invasiveness, reduced blood loss, and shorter hospital stays. Adopting FE could improve clinical outcomes by minimizing postoperative pain and recovery time. The results of this trial were limited by the short follow-up period of 24 months.
Study Summary
60 patients with lumbar spinal stenosis were randomized to receive either full-endoscopic decompression (FE; n=30) or tubular-based microscopic decompression (TM; n=30). The primary outcome of interest was Oswestry Disability Index (ODI) scores at 24 months. Secondary outcomes included ODI scores at all other time points, leg, and back pain on a Visual Analog Scale (VAS), Euro-QoL 5-Dimensions (EQ-5D), walking time, estimated blood loss, length of stay, satisfaction, and the incidence of adverse events. Both groups showed significant improvements from baseline with regard to ODI scores after 24 months. There were significant improvements in all secondary outcomes (back and leg pain, EQ-5D, and walking time). Mean VAS back pain scores showed significant improvements in the FE group compared to the TM group after postoperative day 1, and 6, 12, & 24 months postoperation. Operative and radiation time were similar between the two groups but mean estimated blood loss was significantly lower in the FE group. The results showed that FE is non-inferior to TM for the treatment of lumbar spinal stenosis.
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