Context/objective: At present, there is no consensus on the most effective surgical method for treating symptomatic lumbar spinal stenosis (LSS). Total laminectomy, which is frequently used at this time, destroys the posterior midline structure, causing many postoperative complications. We have designed a new surgical approach instead of total laminectomy. In this paper, we aimed to describe the surgical method of endoscopic modified total laminectomy for lumbar spinal stenosis as well as to explore its early efficacy.

Participants: Patients with symptomatic LSS who underwent endoscopic modified total laminoplasty between August 2016 and August 2017 were eligible for our study.

Outcome measures: Before surgery and one year after surgery, we measured lower limb pain and back pain by visual analog scale (VAS), disability via Oswestry Disability Index (ODI), and severity of back pain according to the Japanese Orthopedic Association Score for Back Pain (JOA), while any complications were also assessed.

Results: Endoscopic modified total laminoplasty was performed on 22 LSS patients, including eight males and 14 females(mean age = 59.3 ± 9.6 years). We found statistically significant differences before and one year after surgery for VAS lower limb pain and back pain, ODI and JOA scores(P < 0.001). Complications included intraoperative dural tears(n = 1),and weak fusion between the lamina and the vertebral body (n = 1).

Conclusion: Endoscopic modified total laminectomy is a promising surgical approach which reduces patient suffering and improves patient quality of life.

背景/目的：目前，对于治疗症状性腰椎管狭窄症（LSS）最有效的手术方法尚未达成共识。此时常用的全椎板切除术破坏了后正中线结构，导致术后并发症较多。我们设计了一种新的手术方法，而不是全椎板切除术。本文旨在介绍内镜下改良全椎板切除术治疗腰椎管狭窄症的手术方法，并探讨其早期疗效。

参与者：在 2016 年 8 月至 2017 年 8 月期间接受内窥镜改良全椎板成形术的有症状的 LSS 患者符合我们的研究条件。

结果测量：手术前和手术后一年，我们通过视觉模拟量表 (VAS) 测量下肢疼痛和背痛，通过 Oswestry 残疾指数 (ODI) 测量残疾，以及根据日本骨科协会背部评分测量背痛的严重程度疼痛（JOA），同时还评估了任何并发症。

结果：22例LSS患者行内镜下改良全椎板成形术，其中男8例，女14例（平均年龄59.3±9.6岁）。我们发现术前和术后1年VAS下肢疼痛和背痛、ODI和JOA评分差异有统计学意义（P < 0.001）。并发症包括术中硬脑膜撕裂（n  =1），椎板与椎体融合不牢固（n  =1）。

结论：内镜下改良全椎板切除术是一种有前途的手术方法，可减少患者痛苦并提高患者生活质量。