Clinical Efficacy Evaluation of Percutaneous Endoscopic Interlaminar Decompression Under Local Anesthesia…

Cohort studyWorld neurosurgery· Jul 2026

Clinical Efficacy Evaluation of Percutaneous Endoscopic Interlaminar Decompression Under Local Anesthesia for the Treatment of Degenerative Lumbar Spinal Stenosis in Elderly Patients with Medical Comorbidities: A Multicenter Retrospective Study.

Shihao Zhou, Zhenxian Qi, Xiaowan Xu … Jiancuo A

SpineCohort studyTreatmentQ2IF 1.8

94% of elderly patients had excellent or good outcomes after awake spinal decompression surgery

Clinical Efficacy Evaluation of Percutaneous Endoscopic Interlaminar Decompression Under Local Anesthesia for the Treatment of Degenerative Lumbar Spinal Stenosis in Elderly Patients with Medical Comorbidities: A Multicenter Retrospective Study.

Shihao Zhou … Jiancuo A

World neurosurgery · Jul 2026 · Q2 in Surgery

Purpose

This study introduces a novel awake percutaneous endoscopic interlaminar discectomy strategy that involves the use of conscious sedation with stepwise local anesthesia (local anesthesia) as an alternative to general anesthesia (general anesthesia).

Methods

This retrospective analysis included 123 consecutive patients older than 70 years with comorbidities who underwent awake percutaneous endoscopic interlaminar discectomy for degenerative lumbar spinal stenosis at 4 hospitals between January 2022 and January 2024.

n = 116 patients

Results

94%

surgery under local anesthesia gave most elderly patients excellent or good results

n = 116 patients

More results

All patients successfully completed percutaneous endoscopic interlaminar discectomy under local anesthesia with conscious sedation.

Overall, 100 patients (81%) rated their intraoperative experience as excellent or good, and 23 patients (19%) rated it as fair.

The mean intraoperative visual analog scale score was 3.4 ± 1.1.

More results

Compared with baseline, leg and back pain visual analog scale scores and Oswestry Disability Index scores improved significantly at all follow-up intervals (P < 0.01).

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Conclusion · 1 of 3

Percutaneous endoscopic interlaminar discectomy under local anesthesia is feasible for elderly patients with lumbar spinal stenosis and severe comorbidities.

Conclusion · 2 of 3

The anesthesia strategy described in this study was safe, simple to implement, and associated with fewer anesthesia-related adverse effects.

Conclusion · 3 of 3

Thus, in selected patients, particularly elderly patients with multiple comorbidities, this approach may serve as a promising alternative to general anesthesia.

Clinical Efficacy Evaluation of Percutaneous Endoscopic Interlaminar Decompression Under Local Anesthesia for the Treatment of Degenerative Lumbar Spinal Stenosis in Elderly Patients with Medical Comorbidities: A Multicenter Retrospective Study.

Clinical Efficacy Evaluation of Percutaneous Endoscopic Interlaminar Decompression Under Local Anesthesia for the Treatment of Degenerative Lumbar Spinal Stenosis in Elderly Patients with Medical Comorbidities: A Multicenter Retrospective Study.

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