Abstract
Endoscopic techniques have garnered positive outcomes in treating lumbar
spinal stenosis, with percutaneous endoscopic transforaminal decompression showing
particular efficacy for addressing stenosis in the intervertebral foramen and lateral
recess. However, the use of transforaminal decompression for central lumbar spinal
stenosis (CLSS) is often met with skepticism. In this section, the authors share insights
from their practice alongside data from a sequential observational study involving 47
CLSS patients treated via a bilateral transforaminal endoscopic approach. Clinical
metrics such as the Oswestry Disability Index (ODI), VAS scores for back and leg
pain, and the Macnab criteria were employed to measure the outcomes. The
radiographic analysis involved comparing the lumbar dural sac's cross-sectional area
before and after the procedure. The findings indicate substantial clinical improvement
and a notable expansion of the dural sac's cross-sectional area at the final follow-up.
There were no reported cases of infection, wound complications, or need for
subsequent surgery. Thus, barring principal pathologies located dorsally to the dural
sac, the bilateral transforaminal endoscopic approach is advocated as an adequate,
reliable, and minimally invasive option for CLSS management.