الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The term lumbar canal stenosis (LCS) refers to the anatomical narrowing of the spinal canal. The characteristic symptom of LCS is neurogenic claudication. LCS has become the most common indication for lumbar spine surgery.
The aim of this study is to assess the role of the posterior lumbar (interlaminar) endoscopic surgery in treatment of lumbar canal stenosis in terms of: feasibility, safety and early operative outcomes..
This prospective study included 30 patients that suffered from lumbar canal stenosis with neurogenic claudication. All patients were presented to the Alexandria Main University Hospital and other affiliated hospitals.
All patients were subjected to informed consent taking before surgery, complete history taking which included the following symptoms: back pain, neurogenic Claudication, sciatica, motor deficit and sphincteric disturbance, full neurological examination, evaluation using Oswestry disability index, routine laboratory investigations, plain x-ray of lumbosacral spine, CT scan of the lumbosacral spine (preoperative and postoperative), magnetic resonance imaging (MRI).
Oswestry disability index (ODI) which was used in this study has been designed to give us information as how patient leg pain is affecting patient’s ability to manage in everyday life activity.
Unilateral full endoscopic uniportal approach was done for single level cases. Operative complications were defined to include incidental durotomy, and blood loss. Postoperative complications were defined to include: CSF leak, early hematoma and spinal instability.
Objective surgical data were obtained; they included the surgical time and estimated blood loss. Postoperative assessment was done immediately, two weeks, three months,6 months postoperative, and 1 year later. All patients were subjected to revising the preoperative symptoms, full neurological examination and evaluation using Oswestry disability index. For all patients, plain x-ray and CT scan of the lumbosacral spine were done postoperatively to ensure the extent of bone removal and adequacy of decompression and assessment of spinal stability.
The study included 30 patients, with mean age (57y). 20 cases (67%) were females and 10 cases (33%) were males. All cases presented with claudicating sciatica, 11 patients(36.7%) complained from unilateral sciatica,19 patients (63.3%) bilateral sciatica,7 patients by partial motor weakness. 22 patients with L4-5 level (73.3%), 6(20%) L3-4 level, one patient (3.3%) for both L2-3 and L5-S1
Duration of surgery ranged from 80 to 180 minutes with mean ± SD (134.7 ± 28.34), Regarding intraoperative blood loss, it ranged from 60 to 280 CC with mean ± SD (147.2 ± 68.30) and median of 130 CC.
In our study intraoperative complications occurred in 4 cases (13%) in the form of dural tear. Early postoperative complications in 5cases (16%) in the form of: superficial wound infection ccurred in 3 cases (10%) and transient dysthesis occurred in 2 case (6%).
In our study the duration of hospital stay ranged between 1 to 3 days with mean ± SD (1.4 ± 0.77) days.
In our study we found that there was a statistically significant difference between VAS pre and post operatively, VAS for sciatic pain was (8.43 ± 1.14) preoperatively, after 2weeks and 1year(2.0 ± 0.83), after 3and6 months(1.50 ± 0.51); improved by 6.43 (95% CI, 5.91 – 6.96).
In this study we found that there was a statistically significant difference between pre and post operatively, ODI was (66.67 ± 7.37) preoperatively, 2 weeks and 3months postoperatively 19.0(15.0–23.0), after 6 months 15.0(11.0–19.0), after 1 year 13.0(10.0–17.0); improved by 53.27 (95% CI, 50.32 – 56.21) after the surgery.