An endoscopic curved Kerrison rongeur for spinal stenosis surgery.
OBJECTIVE
Adequate neural decompression with minimal structural alteration is the goal of lumbar stenosis surgery. Often because of limited visualization significant parts of the facet joints are removed enhancing the potential for developing instability. To overcome this problem we have developed a small curved Kerrison rongeur that contains a 10 000-pixel endoscope. This instrument allows one to visualize and decompress structures within the lateral recess that may have required more extensive removal of portions of the facet joints.


METHODS
Ten patients with symptomatic lumbar spinal stenosis were decompressed using the endoscopic rongeur.


RESULTS
Compression of the lateral dura and nerve root by the facet and ligamentum could easily be identified. In all cases the ligament could be easily removed and the facet joint was undercut only enough to decompress the nerve.


CONCLUSIONS
This instrument has the potential for less invasive decompression of spinal stenosis and further study of its utility is planned.
Frank
E H
EH
Department of Neurosurgery, Oregon Health Sciences University, Portland, Oregon 97201, USA. Franke@ohsu.eou
Martin
J
J
Hsu
F P
FP
D019723:Endoscopes; D004867:Equipment Design; D006801:Humans; D007796:Laminectomy / Q000295:instrumentation*; D008159:Lumbar Vertebrae / Q000601:surgery*; D009408:Nerve Compression Syndromes / Q000601:surgery; D013117:Spinal Cord Compression / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000601:surgery; D013130:Spinal Stenosis / Q000601:surgery*; D013525:Surgical Instruments