A less invasive approach technique for operative treatment of lumbar canal stenosis. Technique and preliminary results.
The aim of this prospective study is to evaluate the efficacy of a less invasive approach for the operative treatment of lumbar canal stenosis. Using transmuscular dilatation this technique minimises surgical trauma. Through a working channel with a 11 mm outer diameter and under operative microscope guidance, decompression of the neural elements can be achieved.


METHODS
From November 1998 to December 2001 38 consecutive patients with a mean age of 73.2 years were operated upon using this technique. The study included 56 lumbar segments. The mean follow up was 32 (18-55) months. The Visual Analogue Scale (VAS) for back and leg pain together with the Oxford Claudication Score (OCS) were used to assess the functional results.


RESULTS
The average operating time for one level decompression was 74 minutes and the average blood loss was 32 ml/patient. Two patients (5.2 %) required revision by open surgery. The OCS improved from 29.4 preoperatively to 16.9 postoperatively (p < 0.001). VAS for back pain and leg pain also showed a significant improvement (p < 0.001).


CONCLUSIONS
This less invasive approach is effective in decompressing lumbar canal stenosis. It has the advantage of early mobilisation and a short hospital stay, especially in elderly patients (mean age here: 73.2 years).
Greiner-Perth
R
R
Department of Orthopaedic Surgery, Spine Surgery and Paraplegiology, Zentralklinik Bad Berka GmbH, Bad Berka. r.greiner.ort@zentralklinik-bad-berka.de
Boehm
H
H
Allam
Y
Y
El-Saghir
H
H
D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019635:Neurosurgical Procedures; D010147:Pain Measurement; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000601:surgery*