title: "Slalom": Microsurgical Cross-Over Decompression for Multilevel Degenerative Lumbar Stenosis.
abstract: Objective. Selective, bilateral multisegmental microsurgical decompression of lumbar spinal canal stenosis through separate, alternating cross-over approaches. Indications. Two-segmental and multisegmental degenerative central and lateral lumbar spinal stenosis. Contraindications. None. Surgical Technique. Minimally invasive, muscle, and facet joint-sparing bilateral decompression of the lumbar spinal canal through 2 or more alternating microsurgical cross-over approaches from one side. Results. From December 2010 until December 2015 we operated on 202 patients with 2 or multisegmental stenosis (115 f; 87 m; average age 69.3 yrs, range 51-91 yrs). All patients were suffering from symptoms typical of a degenerative lumbar spinal stenosis. All patients complained about back pain; however the leg symptoms were dominant in all cases. Per decompressed segment, the average OR time was 36 min and the blood loss 45.7 cc. Patients were mobilized 6 hrs postop and hospitalization averaged 5.9 days. A total of 116/202 patients did not need submuscular drainage. 27/202 patients suffered from a complication (13.4%). Dural tears occurred in 3.5%, an epidural hematoma in 5.5%, a deep wound infection in 1.98%, and a temporary radiculopathy postop in 1.5%. Postop follow-up ranged from 12 to 24 months. There was a significant improvement of EQ 5 D, Oswestry Disability Index (ODI), VAS for Back and Leg Pain, and preoperative standing times and walking distances.
authors: Spine Center, Schön Klinik München Harlaching, Paracelsus Medical School Salzburg, Harlachinger Straße 51, 81547 München, Germany.
authors: H Michael
authors: 0000-0003-2555-8126
authors: HM
authors: Mayer
authors: Spine Center, Schön Klinik München Harlaching, Paracelsus Medical School Salzburg, Harlachinger Straße 51, 81547 München, Germany.
authors: Franziska
authors: 0000-0002-6074-5560
authors: F
authors: Heider
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic / Q000473:pathology / Q000601:surgery; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000209:etiology; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D013122:Spinal Diseases / Q000473:pathology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology