Effects of percutaneous large-channel spinal endoscopic decompression on stress response, lumbar stability, and disability index in elderly patients with single-segment degenerative lumbar spinal stenosis

This study aims to evaluate the effects of percutaneous large-channel spinal endoscopic decompression on stress response, lumbar stability, and disability index in elderly patients with single-segment degenerative lumbar spinal stenosis (LSS). A retrospective analysis was performed on 120 elderly patients with single-segment degenerative LSS treated from January 2020 to January 2024. Fifty-seven underwent percutaneous transforaminal endoscopic discectomy group, and 63 underwent percutaneous large-channel spinal endoscopic decompression (large-channel group). Surgical indicators, complications, stress response, lumbar and leg pain, lumbar function [Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI) score], and lumbar stability were compared. The large-channel group had shorter operative time and fewer intraoperative fluoroscopy sessions than the percutaneous transforaminal endoscopic discectomy group (P<.05), while intraoperative blood loss and incision length were greater (P<.05). Hospital stay and complication rates showed no difference (P>.05). At 3 days postoperatively, serum NE, DA, and 5-HT levels were elevated in both groups (P<.05) but were lower in the large-channel group (P<.05). Lumbar and leg visual analogue scale scores at 1 week, 3 months, and 6 months were lower than preoperative values in both groups (P<.05), with greater improvement in the large-channel group at 3 and 6 months (P<.05). At 1, 3, and 6 months, JOA scores increased and ODI scores decreased in both groups (P<.05). At 3 and 6 months, JOA scores were higher and ODI scores lower in the large-channel group (P<.05). At 6 months, lumbar curvature, lordosis angle, pelvic tilt, and intervertebral space height improved in both groups (P<.05), with greater gains in the large-channel group (P<.05). Percutaneous large-channel spinal endoscopic decompression for elderly patients with single-segment degenerative LSS can shorten operative time, alleviate stenosis and stress response, improve function, and enhance lumbar stability. Its definite efficacy supports clinical application.