Endoscopic Versus Conventional Lumbar Decompression for Lumbar Canal Stenosis (ENDOLSS)
Outcomes Evaluation of Interlaminar Endoscopic Uniportal Bilateral Lumbar Decompression Versus Open Laminectomy for Degenerative Lumbar Canal Stenosis
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
This randomized controlled trial was designed to compare the clinical and surgical outcomes of interlaminar uniportal endoscopic bilateral lumbar decompression versus conventional open laminectomy in patients diagnosed with degenerative lumbar canal stenosis. Lumbar spinal stenosis is a common degenerative condition that results in neurogenic claudication, radicular pain, and functional disability due to compression of neural elements.
The study was conducted at Ain Shams University Hospitals and Damanhour Medical National Institute. Patients meeting inclusion criteria were diagnosed based on clinical evaluation and radiological confirmation using MRI. Eligible patients were randomized into two groups: one group underwent minimally invasive interlaminar uniportal endoscopic bilateral decompression, while the other group underwent conventional open laminectomy.
The primary objective of the study was to compare the effectiveness of both surgical techniques in terms of pain relief and functional improvement. Secondary objectives included comparison of operative time, intraoperative blood loss, postoperative hospital stay, complication rates, muscle injury markers, and time to return to normal activity.
Patients were evaluated preoperatively and postoperatively using standardized clinical assessment tools. Postoperative follow-up was conducted at one day postoperative period, one month, and six months to assess both early and mid-term outcomes.
The hypothesis of the study is that minimally invasive endoscopic decompression provides equivalent or superior clinical outcomes compared to conventional open laminectomy, with the advantage of reduced tissue trauma, less postoperative pain, faster recovery, and shorter hospital stay.
This study aims to contribute to the growing evidence supporting minimally invasive spine surgery techniques and to provide high-quality comparative data to guide surgical decision-making in degenerative lumbar canal stenosis.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Cairo, Egypte
- Ain shams university hospitals
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
Patients diagnosed with degenerative lumbar spinal stenosis based on clinical and radiological findings.
Patients presenting with neurogenic claudication and/or radicular leg pain. Patients indicated for surgical decompression after failure of conservative treatment.
Age 18 years and above. Patients able to provide informed consent.
Exclusion Criteria:
Patients with previous lumbar spine surgery at the same level. Patients with spinal instability requiring fusion. Presence of spinal infection, tumor, or traumatic pathology. Severe comorbid conditions contraindicating surgery. Patients with incomplete clinical or follow-up data.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Endoscopic Decompression Group
Patients undergo interlaminar uniportal endoscopic bilateral lumbar decompression for treatment of degenerative lumbar spinal stenosis.
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Minimally invasive interlaminar uniportal endoscopic decompression of the lumbar spinal canal performed for treatment of degenerative lumbar spinal stenosis.
The procedure aims to relieve neural compression while preserving posterior spinal structures and reducing tissue trauma compared to open surgery.
Autres noms:
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Comparateur actif: Open Laminectomy Group
Patients undergo conventional open laminectomy for treatment of degenerative lumbar spinal stenosis
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Standard open lumbar laminectomy performed for decompression of the spinal canal in patients with degenerative lumbar spinal stenosis.
The procedure involves removal of posterior bony and ligamentous structures to relieve neural compression.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Functional Disability (Oswestry Disability Index - ODI)
Délai: Preoperative, 1 month, and 6 months postoperative
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The Oswestry Disability Index (ODI) will be used to evaluate functional disability related to lumbar spinal stenosis.
The ODI is a validated questionnaire assessing limitations in activities of daily living, including pain intensity, personal care, walking, sitting, standing, and social function.
Scores range from 0 to 100, with higher scores indicating greater disability.
Outcomes will be compared between patients undergoing interlaminar endoscopic and conventional open lumbar decompression.
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Preoperative, 1 month, and 6 months postoperative
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Postoperative Leg Pain (VAS-Leg Score)
Délai: Preoperative, 1 day, 1 month, and 6 months postoperative
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Radicular leg pain will be assessed using the Visual Analogue Scale (VAS), a validated 10-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).
Patients will rate their leg pain intensity preoperatively and at follow-up intervals.
This measure reflects the severity of nerve root compression symptoms and will be used to compare the effectiveness of interlaminar endoscopic versus conventional open lumbar decompression
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Preoperative, 1 day, 1 month, and 6 months postoperative
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Postoperative Back Pain (VAS-Back Score)
Délai: Preoperative, 1 day, 1 month, and 6 months postoperative
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Low back pain intensity will be assessed using the Visual Analogue Scale (VAS), a validated patient-reported outcome measure ranging from 0 (no pain) to 10 (worst imaginable pain).
This scale evaluates the severity of axial back pain associated with degenerative lumbar spinal stenosis.
Measurements will be obtained preoperatively and at follow-up intervals to compare pain relief between interlaminar endoscopic and conventional open lumbar decompression techniques.
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Preoperative, 1 day, 1 month, and 6 months postoperative
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Claudication Distance
Délai: Preoperative, 1 month, and 6 months postoperative
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Claudication distance will be assessed as the maximum walking distance a patient can achieve before the onset of neurogenic claudication symptoms, such as leg pain, numbness, or weakness.
This measure reflects functional limitation due to lumbar spinal stenosis and will be used to evaluate improvement after interlaminar endoscopic versus open lumbar decompression.
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Preoperative, 1 month, and 6 months postoperative
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Operative Time
Délai: Intraoperative
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Duration of surgery measured in hours from skin incision to wound closure in patients undergoing endoscopic versus open lumbar decompression.
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Intraoperative
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Length of Hospital Stay
Délai: From surgery to hospital discharge (typically within 1-5 days postoperative)
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Duration of hospitalization measured in days from surgery to discharge.
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From surgery to hospital discharge (typically within 1-5 days postoperative)
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Postoperative Complications
Délai: Up to 6 months postoperative
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Incidence of postoperative complications including infection, dural tear, neurological deficit, and reoperation.
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Up to 6 months postoperative
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Time to Return to Work
Délai: Up to 6 months postoperative
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Time taken for patients to resume normal daily activities or return to work after surgery.
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Up to 6 months postoperative
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Creatine Phosphokinase (CPK) Level
Délai: 1 day postoperative
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Serum creatine phosphokinase (CPK) levels will be measured as a biomarker of muscle injury associated with surgical intervention.
Levels will be compared between endoscopic and open lumbar decompression groups to assess the degree of muscle damage.
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1 day postoperative
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Mohammad Yousof Aboukila, MD, Ain Shams University, Faculty of Medicine, Department of Neurosurgery
Publications et liens utiles
Publications générales
- Aboukila MY, et al. "Outcomes Evaluation of Interlaminar Endoscopic Uniportal Bilateral Lumbar Decompression versus Open Laminectomy for Degenerative Lumbar Canal Stenosis." Ain Shams University, Department of Neurosurgery, 2026. (Unpublished clinical study / thesis)
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- FMASU MD323/2023
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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