Türk Nöroşirürji Dergisi 2006 , Vol 16 , Num 1
Bilateral Decompression of Lumbar Spinal Stenosis Involving a Unilateral Approach with Microinvasive Surgery
Haseki Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, İstanbul OBJECTIVE: Through this prospective series we have aimed to show magnetic resonance images track the patients and emphasize the results of the cases diagnosed as “spinal stenosis” which were operated with the unilateral approach using bilateral lumbar spinal channel decompression.

METHODS: This 15-case series has been operated by only one surgeon (KK) and all cases were completed through the unilateral microinvasive approach and bilateral spinal lumbar channel decompression. Ten cases were operated under general anesthesia and 5 cases were operated under epidural-spinal anesthesia.

RESULTS: The age range of the cases was 35-76. The average 65.5 and the female to male ratio was 6/9. The cases were followed 1.6 years on average. Those with additional pathologies were not included in this study. In total, 19 levels were decompressed and the average operating duration for each level was 40 minutes. Blood loss averaged around 30 cc for each level. All cases had “severe symptomatic stenosis”. The diameter of the spinal canal was measured preoperatively and postoperatively and the P value was to be found significant statistically. All cases were planned to undergo a neurological examination 1 day, 1 week, 6 weeks, 6 months and 1 and 2 years postoperatively and the spinal channel radius was measured. Cases were evaluated with the visual analog scale (VAS).

CONCLUSION: Microinvasive unilateral lumbar spinal canal decompression is recommended for older aged “symptomatic neurological claudication” patients due to the following advantages: short operation duration, minimum tissue loss, having one-sided “lumbar muscle “column intact, formation of effective spinal channel radius without using instrumentation, having “interspinous ligaments and lamina” intact, acceptable morbidity, early mobilization of the patient and no blood loss. Results in the following 1,5 years were excellent. For more definite results, longer termed and wide ranged tracking is required. Anahtar Kelimeler : Bilateral spinal canal decompression, Lumbar spine, Minimally invasive surgery, Spinal stenosis, Unilateral approach