Artikel
Minimally invasive surgical treatment of lumbar spinal stenosis: about 30 patients operated through a tubular retractor system
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
The objective of this study is estimating the indications, the surgical technique and the outcome of 30 patients presenting a degenerative lumbar spinal stenosis operated by using a tubular retractor system.
Methods
It’s a retrospective study. The surgical method consists in using a tubular retractor system (METRx-MD system, Medtronic Sofamor Danek). Through this working space, it’s possible, by using the microscope, to decompress the lumbar stenosis by interlaminar way. A minimally invasive circumferential decompression is realized without laminectomy but simply laminotomy. These 30 interventions were realized by the same surgeon. Data recorded are: age, level of the lumbar spinal stenosis, initial clinical symptoms, operative time, pain in postoperative, consumption of narcotics medications, average length of stay, follow-up at 1 month and 6 months.
Results
The average length of stay is short (48 hours), the back pain is not important (visual analog scale averages=0,8). This can explain by the absence of invasive dissection, by the absence of muscle detachment and by the absence of use spacers which induce a muscular ischemia. About the post-operative results in 6 months, 94% of the patients are perfectly relieved of the symptoms for which the surgical indication was retained.
Conclusions
In the short-term, means and long-term, the less invasive treatment of lumbar spinal stenosis through a tubular retractor system shows excellent results. The immediate postoperative period is short and not very painful and this allows an earlier renewal of activity. This surgery is a future technique in order to reduce the costs of hospitalization and the costs induced by analgesics medications. This work must be continued in the long-term in order to evaluate lumbar spine stability after this surgery. This method makes it possible to avoid a lumbar pedicle fixation.