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Abstract:

Objective This research tried to investigate the clinical efficacy of endoscopic secondary foraminal shaping in the treatment of lumbar spinal stenosis. Methods A total of 68 cases of lumbar spinal stenosis patients were randomly divided into secondary intervertebral foramen forming percutaneous endoscopic group （observation group）and conventional surgery（control group）. There were 34 cases in each group and the follow up lasted for 6～24 months. The surgical complications，operation time，intraoperative blood loss，hospital stay， hospitalization cost and the effect of surgery were all recorded. The clinical efficacy of the observation group was also documented. Results All68 patients were followed up for an average of 16 months. There was no statistical difference in gender，age or preoperative VAS score（P > 0.05）. Compared with the control group，the observation group had a shorter operation time，less intraoperative bleeding，shorter hospital stay，and less hospital cost，with statistically significant differences（P < 0.05）. After 1 week，1 month，6 months and the last follow⁃up，VAS and ODI scores of the patients in the two groups were all statistically different（P < 0.05）within 1 month，but not statistically different（P > 0.05）after 6 months. Moreover，the improved MacNab standard was used to evaluate the efficacy of the patients one year after the operation without statistically significant difference（P > 0.05）. During the observation period，2 patients in the observation group had repeated symptoms within 1 year，who were patients with central canal stenosis. After the second open operation，the symptoms disappeared；1 patient presented symptoms of intra⁃ operative spinal cord hypertension，and successfully completed the operation after active treatment. In the control group，there was no recurrence. One patient developed epidural hematoma after surgery，and the muscle strength of one side decreased. After emergency hematoma removal，the muscle strength of the lower extremity gradually recovered 3 months later. There were no serious complications such as nerve injury，vascular injury and duraltear. Conclusion Percutaneous endoscopic secondary formingis a safe and effective methodfor the treatment of lumbar spinal stenosis. But it should be used with caution for the treatment of central stenosis. At the same time，it has certain advantages in shortening operation time，reducing bleeding，reducing hospitalization cost and shortening hospitalization time，and has certain promotion value.

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