CURRENT MINIMALLY INVASIVE SURGICAL TECHNIQUES IN NARROWED SPINAL CANAL

Yıl 2013, Cilt: 4 Sayı: 16, 32 - 43, 03.03.2015

Seyit Başarslan Cüneyt Göçmez

Öz

Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and mainly problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with many advantages such as less bleeding, smaller incisions, little muscle distraction and quicker patient recovery. This paper will review the techniques of performing ipsilateral or bilateral decompressions using some microsurgical instruments (microscope, endoscope) and Kit (mild)

Anahtar Kelimeler

Lumbar stenosis, spine, minimal invasive

CURRENT MINIMALLY INVASIVE SURGICAL TECHNIQUES IN NARROWED SPINAL CANAL

Öz

Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and mainly problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with many advantages such as less bleeding, smaller incisions, little muscle distraction and quicker patient recovery. This paper will review the techniques of performing ipsilateral or bilateral decompressions using some microsurgical instruments (microscope, endoscope) and Kit (mild).

Anahtar Kelimeler

Lumbar stenosis, spine, minimal invasive

Kaynakça

• R. A. Deyo, D. C. Cherkin, J. D. Loeser, S. J. Bigos, and M. A. Ciol, “Morbidity and mortality
• in association with operations on the lumbar spine. The influence of age, diagnosis, and procedure,”
• Journal of Bone and Joint Surgery Series A, vol. 74, no. 4, pp. 536–543, 1992.
• D. S. Rosen, J. E. O'Toole, K. M. Eichholz et al., “Minimally invasive lumbar spinal
• decompression in the elderly: outcomes of 50 patients aged 75 years and older,” Neurosurgery, vol.
• , no. 3, pp. 503–509, 2007.
• Z. H. Arinzon, B. Fredman, E. Zohar et al., “Surgical management of H. Hurri, P. Slätis, J.
• Soini et al., “Lumbar spinal stenosis: assessment of long-term outcome 12 years after operative and
• conservative treatment,” Journal of Spinal Disorders, vol. 11, no. 2, pp. 110–115, 1998.
• spinal stenosis: a comparison of immediate and long term outcome in two geriatric patient
• populations,” Archives of Gerontology and Geriatrics, vol. 36, no. 3, pp. 273–279, 2003.
• B. Fredman, Z. Arinzon, E. Zohar et al., “Observations on the safety and efficacy of surgical
• decompression for lumbar spinal stenosis in geriatric patients,” European Spine Journal, vol. 11, no. 6,
• pp. 571–574, 2002.
• J. N. Katz, G. Stucki, S. J. Lipson, A. H. Fossel, L. J. Grobler, and J. N. Weinstein, “Predictors
• of surgical outcome in degenerative lumbar spinal stenosis,” Spine, vol. 24, no. 21, pp. 2229–2233,
• -
• S. J. Atlas, R. B. Keller, D. Robson, R. A. Deyo, and D. E. Singer, “Surgical and nonsurgical
• management of lumbar spinal stenosis: four-year outcomes from the Maine lumbar spine study,”
• Spine, vol. 25, no. 5, pp. 556–562, 2000.
• F. Postacchini, “Surgical management of lumbar spinal stenosis,” Spine, vol. 24, no. 10, pp.
• –1047, 1999.
• L. Bresnahan, A. T. Ogden, R. N. Natarajan, and R. G. Fessler, “A biomechanical evaluation
• of graded posterior element removal for treatment of lumbar stenosis: comparison of a minimally
• invasive approach with two standard laminectomy techniques,” Spine, vol. 34, no. 1, pp. 17–23, 2009.
• F. Asgarzadie and L. T. Khoo, “Minimally invasive operative management for lumbar spinal
• stenosis: overview of early and long-term outcomes,” Orthopedic Clinics of North America, vol. 38,
• no. 3, pp. 387–399, 2007.
• S. Palmer, R. Turner, and R. Palmer, “Bilateral decompression of lumbar spinal stenosis
• involving a unilateral approach with microscope and tubular retractor system,” Journal of
• Neurosurgery, vol. 97, no. 2, pp. 213–217, 2002.
• McCulloch JA, Young PH. Essentials of spinal microsurgery, Philadelphia, Pennsylvania.
• Lippincott-Raven,1998.
• McCulloch JA, Snook D, Kruse CF. Advantages of the operating microscope in lumbar spine
• surgery. Instr Course Lect. 2002;51:243–245. 40.
• Timothy R.Deer, Nagy Mekhail, Gabriel Lopez, Kasra Amirdelfan. Minimally innvasive
• lumbar deconpression for spinal stenosis. JNR 2011; 1(S1): 29-32
• Chopko B, Caraway DL: MiDAS I (mild Decompression Alternative to Open Surgery): a
• preliminary report of a prospective, multi- center clinical study. Pain Physician 13:369-378, 2010.
• Oertel JM, Mondorf Y, Gaab MR. A new endoscopic spine system: The first results with
• "Easy GO". Acta Neurochir (Wien) 2009;151:1027-33.
• 5. Lingreen R, Grider JS: Retrospective review of patient self-reported improvement and
• postprocedure findings for mild (minimally invasive lumbar decompression). Pain Physician 13:555-
• , 2010
• Chiu JC. Endoscopic assisted lumbar microdecompressive spinal surgery with a new SMART
• endoscopic spine system. Surg Technol Int 2006;15:234-41
• Nellensteijn J, Ostelo R, Bartels R, Peul W, van Royen B, van Tulder M. Transforaminal
• endoscopic surgery for lumbar stenosis: A systematic review. Eur Spine J 2010;19:879-86.
• Xu BS, Tan QS, Xia Q, Ji N, Hu YC. Bilateral decompression via unilateral fenestration using
• mobile microendoscopic discectomy technique for lumbar spinal stenosis. Orthop Surg 2010;2:106-
• -
• Wada K, Sairyo K, Sakai T, Yasui N. Minimally invasive endoscopic bilateral decompression
• with a unilateral approach (endo-BiDUA) for elderly patients with lumbar spinal canal stenosis.
• Minim Invasive Neurosurg 2010;53:65-8.
• Deer TR, Kapural L: New image-guided ultra-minimally invasive lumbar decompression
• method: the mild procedure. Pain Physician 13:35-41, 2010.
• Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, Jarvik JG: Trends, major medical
• complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA
• :1259-1265, 2010.