Microsurgical nerve root canal widening without fusion for lumbosacral intervertebral foraminal stenosis: technical notes and early results.
We describe a technique for microsurgical widening of the nerve root canal in the lumbosacral spine. We also report our early results in 31 patients (19 men and 12 women; average follow-up, 3.2 years) with such foraminal stenosis but without osseous defects in the pars interarticularis and/or spondylolisthesis. The affected nerve root was decompressed by interlaminar medial foraminotomy followed by lateral laminotomy and foraminotomy using a microsurgical technique. The procedure aimed at preserving bony continuity of the pars interarticularis and segmental motion. Neurological results showed a favourable improvement of radicular symptoms and of intermittent claudication. The need for segmental fusion at the operated segment was excluded in 30 patients, but one patient subsequently required a transpedicular screw procedure with bone grafting. We recommend the present technique for effective decompression of the nerve root within the neural foramen, simultaneously maintaining lumbar spine mobile function.
Baba
H
H
Department of Orthopaedic Surgery, Fukui Medical School, Matsuoka, Japan.
Uchida
K
K
Maezawa
Y
Y
Furusawa
N
N
Okumura
Y
Y
Imura
S
S
D000200:Action Potentials / Q000502:physiology; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D013126:Spinal Nerve Roots / Q000601:surgery*; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed