The main goal in spinal stenosis surgery is to decompress the nerve structures by widening the narrowed canal. Several different techniques are available.
Laminectomy
It is the procedure of widening the canal by removing the entire lamina bone. It is the most classic and most extensive decompression method. It can be applied at a single or multiple levels.
Bilateral Decompression (Unilateral Approach)
It is the technique of performing decompression on both sides by entering from one side. It provides less muscle damage and faster recovery.1,2 Most of the lamina is preserved; therefore, the risk of instability is lower.3,4
In the presence of instability or accompanying spondylolisthesis, fusion is indicated in addition to decompression.
When is Fusion Added?
Adding fusion to decompression is not always necessary. In the presence of instability or accompanying spondylolisthesis, fusion is indicated in addition to decompression.5,6 If stability is preserved, decompression alone is sufficient.7,8
Minimally Invasive Approaches
Minimally invasive decompression is possible with tubular retractors and endoscopic techniques. Less muscle damage, less blood loss, and shorter hospital stays are its advantages.9,10
→ Next page: S29 — Spondylolisthesis
Kaynaklar
- Liu X et al. Spine (Phila Pa 1976). 2013. PMID 23466507
- Usman M et al. J Coll Physicians Surg Pak. 2013. PMID 24304987
- Moughal S et al. Eur Spine J. 2023. PMID 36437434
- Cavuşoğlu H et al. Eur Spine J. 2007. PMID 17712577
- Resnick DK et al. Neurol Clin. 2022. PMID 35465873
- Hennemann S et al. Rev Bras Ortop (Sao Paulo). 2021. PMID 33627893
- Gadjradj PS et al. Eur Spine J. 2023. PMID 36609887
- Karlsson T et al. Bone Joint J. 2024. PMID 38945544
- Adelhoefer SJ et al. BMC Musculoskelet Disord. 2023. PMID 37919696
- Lokhande PV. J Orthop. 2023. PMID 37197373
Doç. Dr. Özgür Akşan
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