Evidence mapPaperPMID 41858221Full record

ArticleOrthopaedic surgery2026

Percutaneous Endoscopic Lumbar Decompression Using a Novel L-Shaped Impactor for Treating Lumbar Foraminal and Nerve Root Canal Stenosis in Elderly Patients With High Iliac Crests: A Retrospective Cohort Study.

Mengzi Hu, Zhenfei Wang, Quan Zhang, Chunzeng Wang, Jianwei Zhang, Guangwang Liu

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Article in Orthopaedic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Mengzi HuDepartment of Orthopedic Surgery, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Zhenfei WangDepartment of Orthopedic Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.
Quan ZhangDepartment of Orthopedic Surgery, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Chunzeng WangDepartment of Orthopedic Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.
Jianwei ZhangDepartment of Orthopedic Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.
Guangwang LiuDepartment of Orthopedic Surgery, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China.

Funding

Development Fund Project of Affiliated Hospital of Xuzhou Medical University XYFY2020019Health Innovation Teams of Xuzhou XWCX201601Jiangsu Province "333" High-level Talents Program, Innovation Project of Science and Technology of Xuzhou KC20129Jiangsu Provincial Medical Youth Talent QNRC2016392Project of Xuzhou Municipal Health Commission for Introducing Clinical Medical Expert Teams 2019TD002Scientific Research Projects of Jiangsu Provincial Health Commission M2022048-LGY2018047"Six one Projects"for High-level Health Talents in Jiangsu Province LGY2018047Xuzhou Medical Foundation for Youth Reserved Experts Fund 2014006Xuzhou Municipal Medical Leading Talents Program XWRCHT20210035
6 · The paper itself

Abstract

purposeAlthough percutaneous endoscopic lumbar decompression (PELD) has achieved substantial technical advancements over recent decades, it still presents considerable technical challenges in elderly patients with high iliac crest morphology who have concomitant lumbar foraminal stenosis and nerve root canal stenosis. To evaluate the preliminary clinical efficacy of percutaneous endoscopic lumbar decompression (PELD) assisted by an L-shaped impactor system in elderly patients with high iliac crest anatomy complicated by lumbar foraminal stenosis.

methodsA retrospective cohort analysis was conducted on 40 elderly patients with high iliac crest anatomy and radiologically confirmed foraminal stenosis who underwent L-shaped impactor-assisted PELD between January 2022 and August 2023. Patients were divided into early (first 20 cases) and late (latter 20 cases) groups by surgical order. Outcome measures included preoperative/postoperative visual analog scale (VAS) scores for low back/leg pain, Oswestry Disability Index (ODI), MacNab criteria (1 day, 3-month, and 12-month follow-ups), and foraminal anteroposterior diameter, operation time, blood loss, and complications.

resultsVAS scores significantly improved from 6.83 ± 1.03 preoperatively to 3.00 ± 0.72 at 12 months. ODI scores decreased progressively from 55.9 ± 4.9 to 11.7 ± 1.9 at final follow-up. Excellent/good outcomes by MacNab criteria were achieved in 92.5% of patients at 12 months. Complications included transient dysesthesia (one case) and aggravated postoperative low back pain (one case). Compared with the early group, the late group had shorter operation time (58.90 ± 6.91 vs. 66.05 ± 7.26 min), less blood loss (30.85 ± 5.84 vs. 36.10 ± 6.75 mL), and lower postoperative VAS (3.80 ± 1.17 vs. 4.65 ± 1.23 < 0.05).

conclusionThe L-shaped impactor-assisted PELD technique demonstrates favorable clinical efficacy in treating foraminal stenosis in elderly patients with high iliac crest anatomy. A favorable learning curve exists: more experience shortens operative time, reduces blood loss, and improves postoperative pain control without compromising safety. This minimally invasive approach may serve as a feasible surgical option for anatomically complex cases, warranting further prospective validation.

Indexed as

Decompression, SurgicalEndoscopyIliumLumbar VertebraeSpinal StenosisAgedAged, 80 and overFemaleHumansMaleRetrospective StudiesTreatment Outcomeforaminal stenosishigh iliac crestL‐shaped impactorminimally invasive spine surgerypercutaneous endoscopic lumbar decompression

Identifiers

PMID41858221
PMCPMC13056489

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.