Our Summary

This study compares two types of back surgery for elderly patients with a condition called lumbar spinal stenosis, which is a narrowing of the spaces within your spine. The two procedures studied are laminectomy decompression and percutaneous transforaminal endoscopic surgery.

The researchers looked at the results from 65 patients who had the first surgery and 69 who had the endoscopic surgery. They found the endoscopic surgery to be superior in several ways. It took less time, caused less blood loss, and allowed patients to get out of bed and recover faster. Patients also reported less pain after the endoscopic surgery.

Furthermore, patients who had gone through the endoscopic surgery had better scores on two scales that measure back function and disability. There were also fewer cases of urinary tract infections and urinary retention (difficulty emptying the bladder) after the endoscopic surgery compared to the other procedure.

The researchers concluded that the endoscopic surgery is a better option for treating elderly patients with lumbar spinal stenosis than the traditional laminectomy decompression.

FAQs

  1. What are the two types of surgeries compared in the study for treating lumbar spinal stenosis?
  2. Which surgery was found to be more effective in treating lumbar spinal stenosis in elderly patients, according to the study?
  3. What benefits did the endoscopic surgery provide compared to the laminectomy decompression surgery?

Doctor’s Tip

A doctor might advise a patient considering spinal decompression surgery to discuss the option of percutaneous transforaminal endoscopic surgery with their healthcare provider, as it may offer faster recovery, less pain, and better overall outcomes compared to traditional laminectomy decompression.

Suitable For

Spinal decompression is typically recommended for patients with conditions such as herniated discs, bulging discs, degenerative disc disease, spinal stenosis, sciatica, and other spinal conditions that are causing nerve compression and pain. Patients who have not had success with conservative treatments such as physical therapy, medication, and injections may be candidates for spinal decompression surgery. Additionally, patients who are experiencing severe pain, numbness, tingling, weakness, or difficulty walking due to their spinal condition may also be recommended for spinal decompression.

Timeline

Before spinal decompression:

  • Patient experiences symptoms such as back pain, leg pain, numbness, and weakness due to lumbar spinal stenosis
  • Patient undergoes diagnostic tests such as MRI or CT scan to confirm the diagnosis
  • Patient may try conservative treatments such as physical therapy or medication to manage symptoms

After spinal decompression:

  • Patient undergoes either laminectomy decompression or percutaneous transforaminal endoscopic surgery
  • Endoscopic surgery is found to be superior in terms of less time, blood loss, faster recovery, and less pain post-surgery
  • Patients who had endoscopic surgery report better back function and disability scores
  • Fewer cases of urinary tract infections and urinary retention are seen in patients who had endoscopic surgery
  • Researchers recommend endoscopic surgery as a better option for treating lumbar spinal stenosis in elderly patients

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal decompression include:

  1. What are the different types of spinal decompression surgeries available for my condition?
  2. What are the risks and benefits of each type of spinal decompression surgery?
  3. How long is the recovery time for each type of surgery?
  4. Will I need physical therapy after the surgery? If so, how long will I need to attend physical therapy sessions?
  5. What are the potential complications of spinal decompression surgery?
  6. How successful is spinal decompression surgery in relieving pain and improving function?
  7. What is the expected outcome of the surgery in terms of pain relief and mobility improvement?
  8. Are there any alternative treatments to spinal decompression surgery that I should consider?
  9. How many of these surgeries have you performed, and what is your success rate?
  10. What are the long-term effects and potential risks associated with spinal decompression surgery?

Reference

Authors: Zhu H, Liu Y, Wang Y, Xu D, Zhao Z, Wu X. Journal: Ann Med. 2025 Dec;57(1):2472865. doi: 10.1080/07853890.2025.2472865. Epub 2025 Mar 3. PMID: 40033779