Purpose: To evaluate the efficacy of repeat percutaneous endoscopic lumbar decompression (PELD) in lumbar spinal stenosis (LSS) reoperation.
Patients and Methods: This study included patients with LSS who relapsed following treatment with PELD therapy between March 2017 and March 2020. Visual analog scale (VAS) scores and Oswestry Disability Index (ODI) were analyzed preoperatively, postoperatively at 3, 6, 12, and 24 months, and at final follow-up. The modified MacNab criteria were used to assess clinical effects. All complications were recorded.
Results: At a mean follow-up of 3 years, 24 patients with LSS who underwent repeat PELD were identified. The patients’ mean operative time was 122.3± 29.2 min, blood loss was 12.5± 5.3 mL, and mean hospital stay was 7.0± 1.9 days. VAS leg-pain score improved from 6.1± 1.0 to 2.0± 1.2 (P< 0.001), VAS back-pain score improved from 6.2± 0.8 to 2.1± 1.1 (P< 0.001), and ODI improved from 68.9± 6.0 to 20.9± 5.6 (P < 0.001). According to the modified MacNab criteria, the good-to-excellent rate was 83.3%. Postoperative complications, including hematoma, nerve root injury, and dural injury, developed in four patients.
Conclusion: Repeat PELD for reoperation in patients with LSS has a good clinical effect, and is recommended in routine clinical practice. Careful intraoperative manipulation is recommended to prevent complications.
Keywords: lumbar spinal stenosis, percutaneous endoscopic lumbar decompression, reoperation, complication