• Chuan Guo, Daiwen Zhu, Qingquan Kong, Lifeng Zhang, Yu Wang, Jin Yang, Yuqing Yan, Hao Wu, and Zhiyu Peng.
• Orthopaedic Department, West China Hospital, Sichuan University/West China Hospital of Medicine, Sichuan University Chengdu, Sichuan, P.R. China.
• World Neurosurg. 2019 Aug 1; 128: e504-e512.

ObjectiveTo explore the effect and safety of transforaminal percutaneous endoscopic decompression for lower thoracic spinal stenosis.MethodsWe reviewed 6 patients receiving transforaminal percutaneous endoscopic thoracic decompression for sympathetic symptoms in the lower extremities. Pre- and postoperative Frankel grade and Japanese Orthopaedic Association scale (JOA) score, Oswestry Disability Index (ODI) score, and visual analog scale (VAS) scores of back and lower extremities were also evaluated and recorded. Wilcoxon signed-rank test was performed for statistical analysis.ResultsAll 6 patients completed the follow-up. Mean follow-up was 12.6 months. Frankel grade in all patients improved to normal at the third month after operation. JOA scores significantly increased from 4.4 (range, 3.5-5.0) preoperatively to 5.5 (range, 5.0-6.5) postoperatively, to 6.5 (range, 6.0-7.0) at 3 months, to 6.6 (range, 6.2-7.0) at 6 months, and to 6.6 (range, 6.2-7.1) at 12 months (P < 0.05). ODI scores significantly decreased from 71.2 (range, 65-78) preoperatively to 50.2 (range, 45-60) postoperatively, to 30.3 (range, 25-40) at 3 months, to 12.2 (range, 0-20) at 6 months, and to 10.2 (range, 0-15) at 12 months (P < 0.05). VAS back scores decreased from 7.8 (range, 7.0-9.0) preoperatively to 6.9 (range, 6.0-7.5) postoperatively, to 3.3 (range, 3.0-4.0) at 3 months, to 2.3 (range, 2.0-3.0) at 6 months, and to 1.9 (range, 1.5-3.0) at 12 months (P < 0.05). VAS lower extremity scores decreased from 8.7 (range, 8.0-9.0) preoperatively to 3.0 (range, 2.5-3.6) postoperatively, to 1.1 (range, 0.5-1.3) at 3 months, to 0.9 (range, 0.2-1.2) at 6 months, and to 0.3 (range, 0.1-1.0) at 12 months (P < 0.05). Four patients reported excellent results and 2 reported good results at the last follow-up.ConclusionsPercutaneous endoscopic transforaminal thoracic decompression is effective and safe in settling lower thoracic spinal stenosis.Copyright © 2019 Elsevier Inc. All rights reserved.

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