Fully-endoscopic lumbar laminectomy for central and lateral recess stenosis: Technical note
Background: Lumbar central and lateral recess stenosis that results from a degenerative bulging of the disc and overgrowth of the facet is a very common cause for lumbar claudication and radiculopathy in the elderly. The standard surgical treatment for symptomatic lumbar central and lateral recess s...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-09-01
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| Series: | Interdisciplinary Neurosurgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751917302578 |
| _version_ | 1828232429017497600 |
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| author | Ralf Wagner, M.D. Albert E. Telfeian, M.D., Ph.D. Guntram Krzok, M.D. Menno Iprenburg, M.D. |
| author_facet | Ralf Wagner, M.D. Albert E. Telfeian, M.D., Ph.D. Guntram Krzok, M.D. Menno Iprenburg, M.D. |
| author_sort | Ralf Wagner, M.D. |
| collection | DOAJ |
| description | Background: Lumbar central and lateral recess stenosis that results from a degenerative bulging of the disc and overgrowth of the facet is a very common cause for lumbar claudication and radiculopathy in the elderly. The standard surgical treatment for symptomatic lumbar central and lateral recess stenosis often requires a laminectomy. The evolution of minimally invasive techniques have created advantages for patients undergoing surgery and the authors present here a novel technique for endoscopic access to the central and lateral recess pathology that is truly minimally invasive and offers several advantages to minimally invasive spine surgeon. Methods: 14 cases were performed, 10 at L4–5 and 4 at L5-S1, for the treatment of central and lateral recess stenosis. The technique was similar to that performed for minimally invasive lumbar laminectomies with a tubular retractor except, after percutaneous access to the pathological level, a cannulated 11.5 mm tubular retractor was inserted and then a 10 mm outer diameter laminoscope with a 6 mm working channel and 15° lens was inserted. Specialized endoscopic drills, forceps, and kerrison rongeurs were used to remove bony pathology and ligamentum flavum under direct visualization. Results: Following surgery, the patients' symptoms showed immediate regression with continued relief at 6 month and 1 year follow up visits. Conclusions: The availability of endoscopes with larger working channels (laminoscopes) and larger endoscopic instruments and drills now makes treating significant central and lateral recess lumbar stenosis with endoscopic techniques more feasible. Keywords: Endoscopic spine surgery, Minimally-invasive, Laminectomy, Spinal stenosis, Lateral recess, Foraminotomy |
| first_indexed | 2024-04-12T19:21:41Z |
| format | Article |
| id | doaj.art-7e4ad8c5db024b3082e07cdb7cf13cf2 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-04-12T19:21:41Z |
| publishDate | 2018-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-7e4ad8c5db024b3082e07cdb7cf13cf22022-12-22T03:19:35ZengElsevierInterdisciplinary Neurosurgery2214-75192018-09-011369Fully-endoscopic lumbar laminectomy for central and lateral recess stenosis: Technical noteRalf Wagner, M.D.0Albert E. Telfeian, M.D., Ph.D.1Guntram Krzok, M.D.2Menno Iprenburg, M.D.3Ligamenta Spine Centre, Frankfurt am Main, GermanyDepartment of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States; Corresponding author at: Department of Neurosurgery, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, United States.SRH Hospital Waltershausen-Friedrichroda, GermanySpine Clinic Iprenburg, Veenhuizen, NetherlandsBackground: Lumbar central and lateral recess stenosis that results from a degenerative bulging of the disc and overgrowth of the facet is a very common cause for lumbar claudication and radiculopathy in the elderly. The standard surgical treatment for symptomatic lumbar central and lateral recess stenosis often requires a laminectomy. The evolution of minimally invasive techniques have created advantages for patients undergoing surgery and the authors present here a novel technique for endoscopic access to the central and lateral recess pathology that is truly minimally invasive and offers several advantages to minimally invasive spine surgeon. Methods: 14 cases were performed, 10 at L4–5 and 4 at L5-S1, for the treatment of central and lateral recess stenosis. The technique was similar to that performed for minimally invasive lumbar laminectomies with a tubular retractor except, after percutaneous access to the pathological level, a cannulated 11.5 mm tubular retractor was inserted and then a 10 mm outer diameter laminoscope with a 6 mm working channel and 15° lens was inserted. Specialized endoscopic drills, forceps, and kerrison rongeurs were used to remove bony pathology and ligamentum flavum under direct visualization. Results: Following surgery, the patients' symptoms showed immediate regression with continued relief at 6 month and 1 year follow up visits. Conclusions: The availability of endoscopes with larger working channels (laminoscopes) and larger endoscopic instruments and drills now makes treating significant central and lateral recess lumbar stenosis with endoscopic techniques more feasible. Keywords: Endoscopic spine surgery, Minimally-invasive, Laminectomy, Spinal stenosis, Lateral recess, Foraminotomyhttp://www.sciencedirect.com/science/article/pii/S2214751917302578 |
| spellingShingle | Ralf Wagner, M.D. Albert E. Telfeian, M.D., Ph.D. Guntram Krzok, M.D. Menno Iprenburg, M.D. Fully-endoscopic lumbar laminectomy for central and lateral recess stenosis: Technical note Interdisciplinary Neurosurgery |
| title | Fully-endoscopic lumbar laminectomy for central and lateral recess stenosis: Technical note |
| title_full | Fully-endoscopic lumbar laminectomy for central and lateral recess stenosis: Technical note |
| title_fullStr | Fully-endoscopic lumbar laminectomy for central and lateral recess stenosis: Technical note |
| title_full_unstemmed | Fully-endoscopic lumbar laminectomy for central and lateral recess stenosis: Technical note |
| title_short | Fully-endoscopic lumbar laminectomy for central and lateral recess stenosis: Technical note |
| title_sort | fully endoscopic lumbar laminectomy for central and lateral recess stenosis technical note |
| url | http://www.sciencedirect.com/science/article/pii/S2214751917302578 |
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