title: Microsurgical nerve root canal widening without fusion for lumbosacral intervertebral foraminal stenosis: technical notes and early results.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Fukui Medical School, Matsuoka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Baba
authors.forename: K
authors.initials: K
authors.lastname: Uchida
authors.forename: Y
authors.initials: Y
authors.lastname: Maezawa
authors.forename: N
authors.initials: N
authors.lastname: Furusawa
authors.forename: Y
authors.initials: Y
authors.lastname: Okumura
authors.forename: S
authors.initials: S
authors.lastname: Imura
mesh_terms: 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