Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Oct 18, 2024; 15(10): 939-949
Published online Oct 18, 2024. doi: 10.5312/wjo.v15.i10.939
Impact of computed tomography/magnetic resonance imaging registration on rehabilitation after percutaneous endoscopic decompression for lumbar stenosis: Retrospective study
Xiao-Bo Guo, Jin-Wei Chen, Jun-Yang Liu, Jiang-Tao Jin
Xiao-Bo Guo, Jin-Wei Chen, Jun-Yang Liu, Jiang-Tao Jin, Department of Orthopedics, Jincheng General Hospital, Jincheng 048006, Shanxi Province, China
Author contributions: All authors participated in the conception and design of the study and were involved in the acquisition, analysis, and/or interpretation of data; Guo XB and Liu JY wrote the manuscript; Jin JT and Chen JW accessed and verified the study data; All authors have read and approved the final manuscript, and were responsible for the decision to submit it for publication.
Supported by Health Commission of Shanxi Province, No. 2021XM39.
Institutional review board statement: This study was approved by Jincheng General Hospital's Medical Ethics Committee (No. LL2024012201) and was conducted in accordance with the Declaration of Helsinki.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at 44723733@qq.com. Consent was not obtained but the presented data are anonymized, and risk of identification is low. No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jiang-Tao Jin, MD, Chief Doctor, Department of Orthopedics, Jincheng General Hospital, Chang’an Road, Jincheng 048006, Shanxi Province, China. 44723733@qq.com
Received: May 16, 2024
Revised: September 5, 2024
Accepted: September 23, 2024
Published online: October 18, 2024
Processing time: 147 Days and 23.2 Hours
Abstract
BACKGROUND

Percutaneous endoscopic lumbar decompression (PELD) shows promise for lumbar spinal stenosis (LSS) treatment, but its use is limited by the disease's complexity and procedural challenges.

AIM

In this study, the effects of preoperative planning and intraoperative guidance with computed tomography (CT)/magnetic resonance imaging (MRI) registration techniques on PELD for LSS and postoperative rehabilitation outcomes were evaluated.

METHODS

This retrospective study was conducted with data from patients who underwent PELD for LSS between January 2021 and December 2023. Patients were assigned to preoperative CT/MRI registration and control groups. Data collected included the operative time, length of hospital stay, visual analog scale (VAS) scores for low back and leg pain, and the Japanese Orthopaedic Association (JOA) lumbar spine score. Differences between groups were assessed using Student’s t test.

RESULTS

Data from 135 patients (71 in the CT/MRI registration group, 64 in the control group) were analyzed. The operative time was significantly shorter in the CT/MRI registration group (P = 0.007). At 2 months postoperatively, both groups showed significant reductions in VAS leg and low back pain scores (all P < 0.001) and improvements in the JOA score (both P < 0.001). No complication or death occurred. Preoperatively, pain and JOA scores were similar between groups (P = 0.830, P = 0.470, and P = 0.287, respectively). At 2 months postoperatively, patients in the CT/MRI registration group reported lower leg and low back pain levels (P < 0.001 and P = 0.001, respectively) and had higher JOA scores (P = 0.004) than did patients in the control group.

CONCLUSION

Preoperative CT/MRI registration for PELD for LSS reduced the operative time and VAS pain scores at 2 months and improved JOA scores, demonstrating enhanced effectiveness and safety.

Keywords: Endoscopy; Spinal stenosis; Lumbar vertebrae; Tomography; X-Ray computed; Magnetic resonance imaging

Core Tip: This retrospective analysis showed that computed tomography (CT)/magnetic resonance imaging (MRI) registration for percutaneous endoscopic lumbar decompression (PELD) for lumbar spinal stenosis (LSS) treatment significantly reduced visual analog scale pain scores and improved Japanese Orthopaedic Association scores at 2 months postoperatively compared with the control. The control and registration groups showed notable symptom relief with no complications. These findings suggest that CT/MRI registration enhances the safety and effectiveness of PELD for LSS, and improves postoperative outcomes.