Minimally Invasive Decompression in Lumbar Spinal Stenosis

JBJS Essential Surgical Techniques
Greger Lønne, Thomas D Cha

Abstract

Unlike traditional open laminectomy, minimally invasive decompression (MID) spares the important midline structures of the spine (i.e., the spinous process and the supraspinous and interspinous ligaments). Determine the levels and laterality for the decompression on the basis of the symptoms and findings on the MRI scan. Ensure the correct positioning of the patient and the proper setup of the equipment. Use fluoroscopy to localize the level(s) of the stenosis. Ensure the correct placement of the tube. Use a high-speed drill and Kerrison rongeur to enter the spinal canal. Proceed cautiously at the point where the spinal canal is usually narrowest. Resect the ligamentum flavum piecemeal with a Kerrison rongeur. Use the crossover technique to reach across the midline and decompress the contralateral lateral recess (Video 3). Perform a check to be certain that all steps have been completed before closing the skin. In the study by Lønne et al., the 41 patients managed with MID had significant improvement at 6 weeks and throughout the 2-year observation period7.

References

Feb 13, 2002·Spine·Bernard H GuiotRichard G Fessler
Jun 14, 2006·Journal of Spinal Disorders & Techniques·Vinod K PodichettyRobert S Biscup
Jul 17, 2007·The Orthopedic Clinics of North America·Farbod Asgarzadie, Larry T Khoo
Aug 23, 2007·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Halit CavuşoğluYunus Aydin
Jun 9, 2010·Journal of Spinal Disorders & Techniques·Suat Erol CelikIrfan Ince
May 2, 2012·Advances in Orthopedics·Victor Popov, David G Anderson

❮ Previous
Next ❯

Citations

Jan 11, 2019·Arthritis Care & Research·J Denise PowerY Raja Rampersaud

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Zhongguo gu shang = China journal of orthopaedics and traumatology
Ping ZhenYun Xue
Zhongguo gu shang = China journal of orthopaedics and traumatology
Shuan-Chi Wang, Fang-Fang Wang
Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association
Masahito TakahashiShoichi Ichimura
© 2022 Meta ULC. All rights reserved