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Ambulatory Endoscopic Lumbar Foraminotomy for Spinal Stenosis During COVID-19 Pandemic: A 27-Patient Case Series of Transpedicular Approach Under Sedation

Received: 1 June 2022    Accepted: 30 June 2022    Published: 20 July 2022
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Abstract

Background: To demonstrate the safety of the endoscopic lumbar foraminotomy for spinal stenosis and to study clinical outcomes. During the COVID-19 Pandemic there was a lack of beds for elective surgeries that we solved starting to develop ambulatory endoscopic lumbar foraminotomy for foraminostenosis under sedation. Methods: Retrospectively we study 27 patients with foraminostenosis who were operated endoscopically under sedation since October 2020 to October 2021 in our hospital, by a single senior neurosurgeon. Demographics variables and hospital stay times were reviewed. Each patient’s functioning was assessed using the Oswestry Disability Index (ODI) and the visual analog scale (VAS) score for leg pain. Postoperatively, patients were evaluated at 1 month and 1 year. Results: In twenty-seven patients we performed endoscopic foraminotomies under sedation. Eleven were females (40,7%). The average hospital stay time was 6 hours, there was a statistically significant reduction of the preop, post op and final VAS and preop, post op and final ODI. Like the PREOVAS data, POSTOVAS and FVAS do not have normal distribution, a non-parametric ANOVA is performed, obtaining KW = 73.26, p < 0.0001, then, there are statistically significant differences between these three variables. For the variables PREODI, POSTODI and FODI, since they are not normal, a non-parametric ANOVA is performed, obtaining KW = 59.03, p < 0.0001, then, there are statistically significant differences between these three variables. To make comparisons between the VAS and ODI variables, use the Mann Whitney non-parametric method to compare if there is a difference between the medians of the different groups and there is a statistically significant difference between the variables compared with p < 0.0001 in all cases. A Cluster analysis was also made and for elderly patients the reduction of ODI was bigger than the young ones. Conclusions: The authors recommended ambulatory endoscopic lumbar foraminotomy for electives patients when there is a lack of beds in hospital for prolonged stays. There were statistically significant reductions of VAS and ODI score preoperative to post operative with a maximum of 8 hours between the admission to the discharge.

Published in International Journal of Neurosurgery (Volume 6, Issue 2)
DOI 10.11648/j.ijn.20220602.11
Page(s) 32-37
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Spinal Stenosis, Endoscopic Foraminotomy, Minimally Invasive Spine Surgery, Transforaminal Approach

References
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    Carlos Sajama, Gustavo Zomosa, Gonzalo Suarez, Mario Castillo, Gino La Rosa, et al. (2022). Ambulatory Endoscopic Lumbar Foraminotomy for Spinal Stenosis During COVID-19 Pandemic: A 27-Patient Case Series of Transpedicular Approach Under Sedation. International Journal of Neurosurgery, 6(2), 32-37. https://doi.org/10.11648/j.ijn.20220602.11

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    ACS Style

    Carlos Sajama; Gustavo Zomosa; Gonzalo Suarez; Mario Castillo; Gino La Rosa, et al. Ambulatory Endoscopic Lumbar Foraminotomy for Spinal Stenosis During COVID-19 Pandemic: A 27-Patient Case Series of Transpedicular Approach Under Sedation. Int. J. Neurosurg. 2022, 6(2), 32-37. doi: 10.11648/j.ijn.20220602.11

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    AMA Style

    Carlos Sajama, Gustavo Zomosa, Gonzalo Suarez, Mario Castillo, Gino La Rosa, et al. Ambulatory Endoscopic Lumbar Foraminotomy for Spinal Stenosis During COVID-19 Pandemic: A 27-Patient Case Series of Transpedicular Approach Under Sedation. Int J Neurosurg. 2022;6(2):32-37. doi: 10.11648/j.ijn.20220602.11

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  • @article{10.11648/j.ijn.20220602.11,
      author = {Carlos Sajama and Gustavo Zomosa and Gonzalo Suarez and Mario Castillo and Gino La Rosa and Pedro Vergara},
      title = {Ambulatory Endoscopic Lumbar Foraminotomy for Spinal Stenosis During COVID-19 Pandemic: A 27-Patient Case Series of Transpedicular Approach Under Sedation},
      journal = {International Journal of Neurosurgery},
      volume = {6},
      number = {2},
      pages = {32-37},
      doi = {10.11648/j.ijn.20220602.11},
      url = {https://doi.org/10.11648/j.ijn.20220602.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.11},
      abstract = {Background: To demonstrate the safety of the endoscopic lumbar foraminotomy for spinal stenosis and to study clinical outcomes. During the COVID-19 Pandemic there was a lack of beds for elective surgeries that we solved starting to develop ambulatory endoscopic lumbar foraminotomy for foraminostenosis under sedation. Methods: Retrospectively we study 27 patients with foraminostenosis who were operated endoscopically under sedation since October 2020 to October 2021 in our hospital, by a single senior neurosurgeon. Demographics variables and hospital stay times were reviewed. Each patient’s functioning was assessed using the Oswestry Disability Index (ODI) and the visual analog scale (VAS) score for leg pain. Postoperatively, patients were evaluated at 1 month and 1 year. Results: In twenty-seven patients we performed endoscopic foraminotomies under sedation. Eleven were females (40,7%). The average hospital stay time was 6 hours, there was a statistically significant reduction of the preop, post op and final VAS and preop, post op and final ODI. Like the PREOVAS data, POSTOVAS and FVAS do not have normal distribution, a non-parametric ANOVA is performed, obtaining KW = 73.26, p < 0.0001, then, there are statistically significant differences between these three variables. For the variables PREODI, POSTODI and FODI, since they are not normal, a non-parametric ANOVA is performed, obtaining KW = 59.03, p < 0.0001, then, there are statistically significant differences between these three variables. To make comparisons between the VAS and ODI variables, use the Mann Whitney non-parametric method to compare if there is a difference between the medians of the different groups and there is a statistically significant difference between the variables compared with p < 0.0001 in all cases. A Cluster analysis was also made and for elderly patients the reduction of ODI was bigger than the young ones. Conclusions: The authors recommended ambulatory endoscopic lumbar foraminotomy for electives patients when there is a lack of beds in hospital for prolonged stays. There were statistically significant reductions of VAS and ODI score preoperative to post operative with a maximum of 8 hours between the admission to the discharge.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Ambulatory Endoscopic Lumbar Foraminotomy for Spinal Stenosis During COVID-19 Pandemic: A 27-Patient Case Series of Transpedicular Approach Under Sedation
    AU  - Carlos Sajama
    AU  - Gustavo Zomosa
    AU  - Gonzalo Suarez
    AU  - Mario Castillo
    AU  - Gino La Rosa
    AU  - Pedro Vergara
    Y1  - 2022/07/20
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijn.20220602.11
    DO  - 10.11648/j.ijn.20220602.11
    T2  - International Journal of Neurosurgery
    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
    SP  - 32
    EP  - 37
    PB  - Science Publishing Group
    SN  - 2640-1959
    UR  - https://doi.org/10.11648/j.ijn.20220602.11
    AB  - Background: To demonstrate the safety of the endoscopic lumbar foraminotomy for spinal stenosis and to study clinical outcomes. During the COVID-19 Pandemic there was a lack of beds for elective surgeries that we solved starting to develop ambulatory endoscopic lumbar foraminotomy for foraminostenosis under sedation. Methods: Retrospectively we study 27 patients with foraminostenosis who were operated endoscopically under sedation since October 2020 to October 2021 in our hospital, by a single senior neurosurgeon. Demographics variables and hospital stay times were reviewed. Each patient’s functioning was assessed using the Oswestry Disability Index (ODI) and the visual analog scale (VAS) score for leg pain. Postoperatively, patients were evaluated at 1 month and 1 year. Results: In twenty-seven patients we performed endoscopic foraminotomies under sedation. Eleven were females (40,7%). The average hospital stay time was 6 hours, there was a statistically significant reduction of the preop, post op and final VAS and preop, post op and final ODI. Like the PREOVAS data, POSTOVAS and FVAS do not have normal distribution, a non-parametric ANOVA is performed, obtaining KW = 73.26, p < 0.0001, then, there are statistically significant differences between these three variables. For the variables PREODI, POSTODI and FODI, since they are not normal, a non-parametric ANOVA is performed, obtaining KW = 59.03, p < 0.0001, then, there are statistically significant differences between these three variables. To make comparisons between the VAS and ODI variables, use the Mann Whitney non-parametric method to compare if there is a difference between the medians of the different groups and there is a statistically significant difference between the variables compared with p < 0.0001 in all cases. A Cluster analysis was also made and for elderly patients the reduction of ODI was bigger than the young ones. Conclusions: The authors recommended ambulatory endoscopic lumbar foraminotomy for electives patients when there is a lack of beds in hospital for prolonged stays. There were statistically significant reductions of VAS and ODI score preoperative to post operative with a maximum of 8 hours between the admission to the discharge.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Neurosurgery Unit, Department of Surgery, Chilean Air Force Clinical Hospital, Santiago, Chile

  • Neurosurgery Unit, Department of Surgery, Chilean Air Force Clinical Hospital, Santiago, Chile

  • Neurosurgery Unit, Department of Surgery, Chilean Air Force Clinical Hospital, Santiago, Chile

  • Neurosurgery Unit, Department of Surgery, Chilean Air Force Clinical Hospital, Santiago, Chile

  • Anesthesiology Department, Chilean Air Force Clinical Hospital, Santiago, Chile

  • Department of Statistics and Econometrics, Universidad Tecnológica Metropolitana, Santiago, Chile

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