MINIMALLY INVASIVE SPINAL CANAL RECONSTRUCTION FOR DEGENERATIVE LUMBAR SPINAL STENOSIS
https://doi.org/10.14531/ss2017.3.67-73
Abstract
Objective. To analyze early results of surgical treatment in patients with lumbar spinal stenosis using minimally invasive techniques for reconstruction of the spinal canal and fixation of the spine.
Material and Methods. A total of 168 patients were treated with minimally invasive unilateral microsurgical decompression for spinal stenosis at the lumbar level.
Results. The average length of post-operative inpatient care was 5.8 ± 2.8 days. When assessing the pain intensity in the legs and lumbar spine, as well as in daily activity, positive dynamics was noted after 1 and 6 months. Of the installed 732 screws, 18 (2.4 %) screws were displaced into the spinal canal by less than 2 mm and 4 (0.5 %) – by less than 4 mm. Signs of persistent subcompensated spinal stenosis at the operated level were detected in 5 (2.9 %) patients. The average intraoperative blood loss was 121.1 ± 22.0 ml. All patients were activated at the first day after surgery.
Conclusion. Minimally invasive unilateral decompression, if necessary in combination with correction and fixation with percutaneous pedicle screw system and TLIF, eliminates factors causing compression of neural structures, reduces intraoperative blood loss, allows early activation of patients and shortens the length of hospital stay.
About the Authors
Valery B. Lebedev
Pirogov National Medical and Surgical Center
Russian Federation
MD, PhD, traumatologist-orthopaedist, Pirogov National Medical and Surgical Center, Moscow, Russia
Russian Federation
MD, PhD, traumatologist-orthopaedist, Pirogov National Medical and Surgical Center, Moscow, Russia
Dmitry S. Epifanov
Pirogov National Medical and Surgical Center
Russian Federation
neurosurgeon, Pirogov National Medical and Surgical Center, Moscow, Russia
Russian Federation
neurosurgeon, Pirogov National Medical and Surgical Center, Moscow, Russia
Gleb V. Kostenko
Pirogov National Medical and Surgical Center
Russian Federation
postgraduate student, Pirogov National Medical and Surgical Center, Moscow, Russia
Russian Federation
postgraduate student, Pirogov National Medical and Surgical Center, Moscow, Russia
Tousif S. Ghodivala
Pirogov National Medical and Surgical Center
Russian Federation
resident physician, Pirogov National Medical and Surgical Center, Moscow, Russia
Russian Federation
resident physician, Pirogov National Medical and Surgical Center, Moscow, Russia
Renat M. Nurmukhametov
Pirogov National Medical and Surgical Center
Russian Federation
resident physician, Pirogov National Medical and Surgical Center, Moscow, Russia
Russian Federation
resident physician, Pirogov National Medical and Surgical Center, Moscow, Russia
Nikita V. Pedyash
Pirogov National Medical and Surgical Center
Russian Federation
neurosurgeon, Pirogov National Medical and Surgical Center, Moscow, Russia
Russian Federation
neurosurgeon, Pirogov National Medical and Surgical Center, Moscow, Russia
Andrey A. Zuev
Pirogov National Medical and Surgical Center
Russian Federation
MD, PhD, neurosurgeon, Head of Neurosurgery Department No. 2, Pirogov National Medical and Surgical Center, Moscow, Russia
Russian Federation
MD, PhD, neurosurgeon, Head of Neurosurgery Department No. 2, Pirogov National Medical and Surgical Center, Moscow, Russia
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Review
For citations:
Lebedev V.B., Epifanov D.S., Kostenko G.V., Ghodivala T.S., Nurmukhametov R.M., Pedyash N.V., Zuev A.A. MINIMALLY INVASIVE SPINAL CANAL RECONSTRUCTION FOR DEGENERATIVE LUMBAR SPINAL STENOSIS. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2017;14(3):67-73. https://doi.org/10.14531/ss2017.3.67-73
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