ORIGINAL
Introdução: A estenose lombar degenerativa é uma causa frequente de incapacidade, e a descompressão totalmente endoscópica tem surgido como alternativa minimamente invasiva, embora ainda haja poucas evidências brasileiras. Objetivo: Avaliar a segurança, a viabilidade e os desfechos clínicos da descompressão lombar totalmente endoscópica em um centro neurocirúrgico brasileiro. Métodos: Esta série retrospectiva incluiu 45 pacientes tratados entre maio de 2021 e novembro de 2024. Um único neurocirurgião realizou todos os procedimentos por via interlaminar ou transforaminal. Foram analisados dados demográficos, intraoperatórios e pós-operatórios. Os desfechos primários foram complicações e melhora pela Escala Visual Analógica (EVA) aos seis meses (p < 0,05). Resultados: A média de idade foi de 50,7 anos; 56% eram mulheres. L4–L5–S1 foi tratado em 75,5% dos casos. O tempo operatório médio foi de 150 minutos, com perda sanguínea de 40 mL e ausência de lesões durais ou nervosas. As complicações incluíram parestesia transitória (6,7%) e um hematoma epidural autolimitado (2,2%). A EVA reduziu de 9,1 para 3,3 (p < 0,0001). Não houve reoperações ou infecções, e a internação média foi de 0,3 dia. Conclusão: A descompressão lombar totalmente endoscópica mostrou-se segura, eficaz e reprodutível, oferecendo excelentes resultados de curto prazo para estenose lombar nesta coorte brasileira.
Introduction: Degenerative lumbar spinal stenosis is a frequent cause of disability, and full-endoscopic decompression has emerged as a minimally invasive alternative, though Brazilian evidence remains limited. Objective: To evaluate the safety, feasibility, and clinical outcomes of full-endoscopic lumbar decompression at a Brazilian neurosurgical center. Methods: This retrospective series included 45 patients treated between May 2021 and November 2024. A single neurosurgeon performed all procedures using interlaminar or transforaminal approaches. Demographic, intraoperative, and postoperative data were analyzed. Primary outcomes were complications and improvement on the Visual Analog Scale (VAS) at six months (p < 0.05). Results: Mean age was 50.7 years; 56% were female. L4–L5–S1 was treated in 75.5% of cases. Mean operative time was 150 minutes, with 40 mL blood loss and no dural or nerve injuries. Complications included transient paresthesia (6.7%) and one self-limited epidural hematoma (2.2%). VAS improved from 9.1 to 3.3 (p < 0.0001). No reoperations or infections occurred, and hospital stay averaged 0.3 days. Conclusion: Full-endoscopic lumbar decompression was safe, effective, and reproducible, providing excellent short-term outcomes for lumbar stenosis in this cohort.
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1Fundação de Neurologia e Neurocirurgia, Instituto do Cérebro, Salvador, BA, Brazil.
2Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Received Oct 17, 2025
Corrected Nov 26, 2025
Accepted Nov 27, 2025
