scholarly journals Lumbar Spinal Stenosis: Ipsilateral Facet-sparing Unilateral Laminotomy for Bilateral Decompression: Technical Note and Preliminary Results

2021 ◽  
Author(s):  
Luca Papavero ◽  
Kathrin Schawjinski ◽  
Nawar Ali ◽  
Justus Oehm ◽  
Markus Pietrek ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Technical Note ◽  
Preliminary Results ◽  
Lumbar Spinal

scholarly journals Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results

2016 ◽  
Vol 24 (4) ◽  
pp. 602-607 ◽  
Author(s):  
Jin Hwa Eum ◽  
Dong Hwa Heo ◽  
Sang Kyu Son ◽  
Choon Keun Park
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Excellent Result ◽  
Technical Note ◽  
Decompression Surgery ◽  
Lumbar Stenosis ◽  
Continuous Irrigation ◽  
Endoscopic Decompression ◽  
Alternative Treatment Option ◽  
Lumbar Spinal

OBJECTIVE The use of conventional uniportal spinal endoscopic decompression surgery for lumbar spinal stenosis can be limited by technical difficulties and a restricted field of vision. The purpose of this study is to describe the technique for percutaneous biportal endoscopic decompression (PBED) for lumbar spinal stenosis and analysis of clinical postoperative results. METHODS The authors performed a unilateral laminotomy with bilateral foraminal decompression using a unilateral biportal endoscopic system in patients with single-level lumbar stenosis. The authors enrolled only patients who underwent follow-up for longer than 12 months after PBED. Fifty-eight patients were enrolled in this study. This approach was based on 2 portals: one portal was used for continuous irrigation and endoscopic viewing and the other portal was used to manipulate the instruments used in the decompression procedures. Clinical parameters such as the Oswestry Disability Index (ODI), Macnab criteria, and postoperative complications were analyzed. RESULTS Neural decompression was effectively performed in all enrolled patients. The mean ODI was significantly lower after PBED. Of 58 patients, 47 (81.0%) had a good or excellent result according to the Macnab criteria. Postoperative ODI and visual analog scale scores were significantly improved compared with preoperative values. CONCLUSIONS From a surgical point of view, percutaneous biportal endoscopy is very similar to microscopic spinal surgery, permitting good visualization of the contralateral sublaminar and medial foraminal areas. The authors suggest that the PBED, which is a minimally invasive procedure, is an alternative treatment option for degenerative lumbar stenosis.

Internal Decompression for Multiple Levels of Lumbar Spinal Stenosis: A Technical Note

Neurosurgery ◽  
1982 ◽  
Vol 11 (4) ◽  
pp. 546-549 ◽  
Author(s):  
Paul M. Lin
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Spinal Canal ◽  
Posterior Lumbar Interbody Fusion ◽  
Pain Syndrome ◽  
Technical Note ◽  
Canal Stenosis ◽  
Spinous Processes ◽  
Multiple Levels ◽  
Lumbar Spinal

Abstract In cases of lumbar spinal stenosis, use of the wide decompressive procedure for neural compression without regard for the integrity of facets tends to lead to instability and the chronic pain syndrome. Experience with the posterior lumbar interbody fusion technique indicates that, in cases of multiple levels of spinal canal stenosis, the decompression can be made adequately by inferior and superior marginal laminotomy, mesial facetectomy with an osteotome, and foraminotomy with an angle bone punch and a supersonic curette. Internal thinning of the thickened lamina can be achieved by the shaving action of the supersonic curette done from within the spinal canal. This technique achieves the necessary internal decompression of the multiple levels of spinal stenosis without interruption of the integrity of the motion segment. The spinous processes and the supraspinous ligaments and the lateral half of the facet, with its firm fibrous capsules, are scrupulously preserved. The disc is not removed unless it is overtly extruded.

Partial Pediculectomy in the Treatment of Lumbar Spinal Stenosis: Technical Note

Neurosurgery ◽  
1997 ◽  
Vol 41 (1) ◽  
pp. 308-310 ◽  
Author(s):  
Jonas M. Sheehan ◽  
Gregory A. Helm ◽  
David F. Kallmes ◽  
Christopher A. Bogaev ◽  
John A. Jane
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Technical Note ◽  
Lumbar Spinal

scholarly journals Treatment of Lumbar Spinal Stenosis by Microscopic Unilateral Laminectomy for Bilateral Decompression: A Technical Note

2017 ◽  
Vol 9 (2) ◽  
pp. 241-246 ◽  
Author(s):  
Kevin Phan ◽  
Ian Teng ◽  
Konrad Schultz ◽  
Ralph J Mobbs
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Technical Note ◽  
Lumbar Spinal

scholarly journals Interspinous Spacer Implant in Patients with Lumbar Spinal Stenosis: Preliminary Results of a Multicenter, Randomized, Controlled Trial

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Larry E. Miller ◽  
Jon E. Block
Keyword(s):  
Randomized Controlled Trial ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Controlled Trial ◽  
Conservative Care ◽  
Preliminary Results ◽  
Interspinous Spacer ◽  
Randomized Controlled ◽  
Back Function ◽  
Lumbar Spinal

A prospective, randomized, controlled trial was conducted to compare clinical outcomes in patients treated with an investigational interspinous spacer (Superion) versus those treated with an FDA-approved spacer (X-STOP). One hundred sixty-six patients with moderate lumbar spinal stenosis (LSS) unresponsive to conservative care were treated randomly with the Superion (n=80) or X-STOP (n=86) interspinous spacer. Study subjects were followed through 6 months posttreatment. Zurich Claudication Questionnaire (ZCQ) symptom severity scores improved 30% with Superion and 25% with X-STOP (both P<0.001). Similar changes were noted in ZCQ physical function with improvements of 32% with Superion and 27% with X-STOP (both P<0.001). Mean ZCQ patient satisfaction score ranged from 1.7 to 2.0 in both groups at all follow-up visits. The proportion of subjects that achieved at least two of three ZCQ clinical success criteria at 6 months was 75% with Superion and 67% with X-STOP. Axial pain decreased from 55±27 mm at pretreatment to 22±26 mm at 6 months in the Superion group (P<0.001) and from 54±29 mm to 32±31 mm with X-STOP (P<0.001). Extremity pain decreased from 61±26 mm at pretreatment to 18±27 mm at 6 months in the Superion group (P<0.001) and from 64±26 mm to 22±30 mm with X-STOP (P<0.001). Back function improved from 38±13% to 21±19% with Superion (P<0.001) and from 40±13% to 25±16% with X-STOP (P<0.001). Preliminary results suggest that the Superion interspinous spacer and the X-STOP each effectively alleviate pain and improve back function in patients with moderate LSS who are unresponsive to conservative care.

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