Experts Consensus on Endoscopic Posterior Lumbar Decompression for Lumbar Spinal Stenosis (2022)

Title: Experts Consensus on Endoscopic Posterior Lumbar Decompression for Lumbar Spinal Stenosis (2022)
Edition: Original
Classification: Experts consensus
Field: Treatment
Countries and regions: China
Guidelines users: Spine surgeons
Evidence classification method: 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence
Development unit: Minimally Invasive Group, Orthopedic Branch of Beijing Medical Association; Minimally Invasive Group, Department of Orthopedics Surgery, Capital Medical University
Registration time: 2022-11-13
Registration number: PREPARE-2022CN725
Purpose of the guideline: Lumbar spinal stenosis (LSS) is due to congenital or acquired and other factors causing changes in the volume of the spinal canal, resulting in lumbar nerve tissue compression and blood circulation disorders, presenting clinical symptoms of hip or lower limb pain, neurogenic claudication, with or without lumbar pain. Surgical treatment of LSS is suitable for patients with severe symptoms for more than 3-6 months and poor effect of conservative treatment. Open decompression with/without internal fixation and fusion is the classic operation for the treatment of LSS. In recent years, with the development of minimally invasive spinal surgery technology, endoscopic posterior lumbar decompression (EPLD) represented by microendoscopy (MED), uniportal endoscopic spinal surgery, UESS), and biportal endoscopic spinal surgery (BESS)/ unilateral biportal endoscopy (UBE) has been applied in the treatment of LSS, showing satisfactory outcome and technical advantage. However, due to the different levels of surgeons' grasp of EPLD for LSS, the lack of strict grasp of surgical indications and contraindications, and the non-standard perioperative management, some LSS patients experienced poor clinical results and complications after EPLD surgery. Therefore, our experts’ consensus aims to develop basic norms related to EPLD for LSS, to guide spinal surgeons to carry out EPLD in a reasonable and standard way, further improving the clinical efficacy of LSS patients receiving minimally invasive spinal endoscopic surgery.