Publikation

Facet-Sparing Decompression of Lumbar Spinal Stenosis: The Minimally Invasive Bilateral Crossover Approach

Wissenschaftlicher Artikel/Review - 21.01.2021

PubMed
DOI

Zitation
Klingler J, Hubbe U, Scholz C, Krüger M. Facet-Sparing Decompression of Lumbar Spinal Stenosis: The Minimally Invasive Bilateral Crossover Approach. J Neurol Surg A Cent Eur Neurosurg 2021
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
J Neurol Surg A Cent Eur Neurosurg 2021
Veröffentlichungsdatum
21.01.2021
eISSN (Online)
2193-6323
Kurzbeschreibung/Zielsetzung

BACKGROUND AND STUDY OBJECTIVE
 One risk of established decompression techniques for lumbar spinal stenosis is the resection of facet joints, especially if they are steeply configured, promoting destabilization. aims to preserve the facet joints and thus stability of the spine. The purpose of this study is to demonstrate the feasibility and early results of this technique.

METHODS
 This retrospective case series includes 10 consecutive patients with lumbar stenosis and steep-angle (<35 degrees) facet joints who were treated with minimally invasive bilateral crossover decompression. Eleven segments were decompressed, most commonly L3/L4 (63.6%), followed by L1/L2 and L2/L3 (18.2% each). The effectiveness of surgical decompression was assessed by self-reporting questionnaires.

RESULTS
 After a follow-up of 10.5 months, the Symptom Severity Scale and Physical Function Scale of the Swiss Spinal Stenosis Questionnaire improved by 0.9 ( < 0.05) and 0.7 points, respectively. The mean Oswestry Disability Index improved from 53.9 to 34.6 ( < 0.05). Local and radiating pain under strain showed statistically significant improvement on the Visual Analog Scale (8.9 vs. 5.0 and 8.4 vs. 4.6, respectively). Maximum walking distance increased from 190 to 1,029 m. Apart from one patient requiring surgical decompression of an adjacent segment, there were no reoperations, neurological deteriorations, or other complications.

CONCLUSION
 The results of this study indicate is a promising technique for the treatment of spinal canal stenosis. With its design to spare facet joints, it can potentially reduce the risk of spinal instability, especially in patients with steep facet joints.