Original Article

Bilateral Decompression In Lumbar Spinal Stenosis Through A Unilateral Posterior Endoscopic Approach. Surgical Technique And Results About 300 Cases

J Destandau

Citation

J Destandau. Bilateral Decompression In Lumbar Spinal Stenosis Through A Unilateral Posterior Endoscopic Approach. Surgical Technique And Results About 300 Cases. The Internet Journal of Minimally Invasive Spinal Technology. 2010 Volume 4 Number 1.

Abstract

Study Design: This endoscopic surgical technique has been used by the author since 1993 for disc prolapses and since 2001 for lumbar spinal stenosis. Surgical technique is described and results of 300 cases are presented.Material and Methods: The device (Endospine, Karl Storz GmbH, Tuttlingen, Germany) is composed of three tubes: one for the endoscope, one for suction canula and the largest one for classical surgical instruments. Since 2001 this endoscopic technique has been used in spinal stenosis performing a bilatéral décompression through a posterior approach on the left side or on the side of prédominant signs. From February 2001 to December 2010, 300 patients have been operated on with this technique. In 86% surgery was a single level décompression and in 15% there was an associated spondylolisthesis. Prolo’s criteria were used. Results: 218 questionnaires (73%) were returned showing excellent results in 196 cases (90%) and poor in 21 (10%). With an average delay of 3 weeks, 194 patients (89%) returned to a normal life. Eleven patients (3,7%) needed a second operation with an average delay of 13 months. The complications observed were: dural tear in 20 (6,7%); nerve root lesion in 4 (1,3%); resection of articular process in 14 (4,7%); wrong level décompression in 2 (0,7%); and 1 compressive hematoma (0,3%) ; no infection. In answer to the questions on global satisfaction and on the accuracy of the information given before surgery, 98% responded as satisfied and 97% felt the information given to be accurate. Conclusions: This minimally invasive technique is mainly used in single level spinal stenosis even with associated spondylolisthesis, but can be also used in several levels décompression. The good results and the fast resumption of normal activities explain that this endoscopic technique could become the gold standard in spinal stenosis, pathology that is increasing with the lifespan extension

 

References

Author Information

Jean Destandau

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