Microdecompression for lumbar spinal canal stenosis

Abstract

Study design: A description of the technique for lumbar microdecompression and a prospective study of the outcomes.

Objective: To describe and analyze a technique that affords an excellent decompression while minimizing damage to surrounding tissues.

Summary of background data: Commonly used techniques of lumbar decompression that include bilateral takedown of paraspinal musculature and aggressive bony resection can result in significant iatrogenic sequelae. A less destructive alternative is needed.

Methods: Unilateral limited takedown of multifidus was undertaken, and ipsilateral decompression performed. The contralateral side then was addressed under the midline structures with microscopic visualization--thereby preserving the supra-/interspinous ligament complex and the contralateral musculature. Thirty consecutive patients undergoing the procedure were analyzed prospectively and after a follow-up period by independent observers using a modified validated functional outcome score and patient satisfaction measures.

Results: The technique affords an excellent decompression while minimizing destruction to tissues not directly involved in the pathologic process. Functional outcome scores doubled, and 87% of patients reported high satisfaction rates.

Conclusions: Lumbar microdecompression is a minimally invasive technique that appears to provide excellent functional outcomes.