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Abstract Methods The data of 46 elderly patients of foraminal stenosis with degenerative lumbar scoliosis treated by endoscopic visual ring saw from March 2020 to May 2021 were retrospectively analyzed.There were 25 males and 21 females，aged 72~85 years，with an average age of (77.5±2.6) years.There were 35 cases of responsible segment L4～5 and 11 cases of L5S1.Endoscopic Endo-surgy standard surgical instrument set was used to enlarge and reconstruct the foraminal foramina，and the hypertrophic yellow ligament on the dorsal side of the foramina and the intraforaminal hypertrophic ligament were removed using a nucleus pulposus forceps.For patients with significant lumbar disc herniation，the protruded nucleus pulposus was removed intraoperatively to fully enlarge the narrow foramina.Surgical blood loss，operation time，hospital stay and postoperative complications were recorded.Postoperative lumbar hyperextension and flexion lateral Xray was improved to evaluate the stability of the lumbar spine，lumbar anteroposterior X-ray to evaluate the changes of lumbar scoliosis，and lumbar CT to observe the degree of foraminal decompression.visual analogue scale (VAS) was used to evaluate the degree of pain before surgery and 1，6 and 12 months after surgery.The severity of lumbar dysfunction was evaluated according to the Oswestry disability index(ODI) before surgery and at 1，6 and 12 months after surgery.One year after surgery，the efficacy was evaluated according to the functional criteria of lumbar MacNab.Results All the operations were successful without any complications such as vascular and nerve injury.The intraoperative blood loss was (22.38±4.64) mL，the operative time was (52.95±4.98) min，and the postoperative hospital stay was (3.00±0.45) d.Postoperative lumbar CT examination in all patients showed sufficient decompression in the foraminal area.Postoperative review of lumbar hyperextension and flexion lateral radiographs showed good lumbar stability.Postoperatively，lumbar anteroposterior radiographs showed no progress in scoliosis.46 cases were followed up for 12~24 months，with an average of (18.32±2.55) months.According to MacNab standard，39 cases were excellent，3 cases were good，and 4 cases were fair，with an excellent and good rate of 91.30%.VAS and ODI scores at 1，6 and 12 months after surgery were significantly improved compared with those before surgery (P＜0.001).Conclusion Endoscopic visual ring saw technique is a safe and effective minimally invasive method for treating senile foraminal stenosis with degenerative lumbar scoliosis.
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Corresponding Authors:
Cheng Cai
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