From clinic to hypothesis, an innovative operation for the treatment of lumbar spinal stenosis in a minimal invasive way

Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and/or problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time-honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with less bleeding, smaller incisions, and quicker patient recovery. This paper will review the technique of performing ipsilateral and bilateral decompressions using a tubular retractor system and microscope.

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Metrics Development for Minimal Invasive Unilateral Laminotomy for Bilateral Decompression of Lumbar Spinal Stenosis With and Without Spondylolisthesis by an International Expert Panel

Global Spine Journal ◽

10.1177/2192568219893675 ◽

2020 ◽

Vol 10 (2_suppl) ◽

pp. 168S-175S ◽

Cited By ~ 1

Author(s):

Carolin Melcher ◽

Andreas Korge ◽

Michael Cunningham ◽

Kevin T. Foley ◽

Roger Härtl

Keyword(s):

Clinical Practice ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Performance Metrics ◽

Minimal Invasive ◽

Delphi Panel ◽

Decompression Surgery ◽

Modified Delphi ◽

And Performance ◽

Lumbar Spinal

Study Design: Prospective study. Objectives: To develop, operationally define, and seek consensus from procedure experts on the metrics that best characterize a reference approach to the performance of a minimally invasive unilateral laminotomy for bilateral decompression (ULBD) for lumbar spinal stenosis. Methods: A Metrics Group consisting of 3 experienced spine surgeons (2 neurosurgeons, 1 orthopedic surgeon), each with over 25 years of clinical practice, and an educational expert formed the Metrics Group that characterized a lumbar decompression surgery for spinal stenosis as a “reference” procedure. In a modified Delphi panel, 26 spine surgeons from 14 countries critiqued these metrics and their operational definitions before reaching consensus. Results: Performance metrics consisting of 6 phases with 42 steps, 21 errors, and 17 sentinel errors were identified that characterize the procedure. During the peer review, these were evaluated, modified, and agreed. Conclusions: Surgical procedures can be broken down into elemental tasks necessary for the safe and effective completion of a reference approach to a specified surgical procedure. Spinal experts from 16 countries reached consensus on performance metrics for the procedure. This metric-based characterization can be used in a training curriculum and also for assessment of training and performance in clinical practice.

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Treatment of the Moderate Lumbar Spinal Stenosis with an Intespinous Distraction Device IMPALA

Journal of Health Sciences ◽

10.17532/jhsci.2013.74 ◽

2013 ◽

Vol 3 (2) ◽

pp. 113-116

Author(s):

Haso Sefo ◽

Mersad Barucija ◽

Edin Hajdarpasic ◽

Mirsad Muftic

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Clinical Symptoms ◽

Minimal Invasive ◽

Safe Procedure ◽

Clinical Evaluations ◽

Distraction Device ◽

The Mean ◽

Interspinous Distraction ◽

Lumbar Spinal

Introduction: The aim of this study was the evaluation of symptom improvements in patients with moderate lumbar spinal stenosis, who consecutively underwent placement of interspinous distraction deviceIMPALA®.Methods: This study included a total of 11 adult patients with moderate lumbar spinal stenosis. Clinical evaluations were performed preoperatively and 3-months after surgery using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI).Results: The mean preoperative VAS was 7.09 and fell to 2.27 a 3-months after surgery. The mean preoperative ODI was 59.45 fell to 20.72 a 3-months after surgery.Conclusions: Using the IMPALA® device in patients with moderate lumbar spinal stenosis is a minimal invasive, effective and safe procedure. Clinical symptoms were improved 3 months after surgery.

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