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We describe a technique for microsurgical widening of the nerve root canal in the lumbosacral spine. We also report our early results in 31 patients (19 men and 12 women; average follow-up, 3.2 years) with such foraminal stenosis but without osseous defects in the pars interarticularis and/or spondylolisthesis. The affected nerve root was decompressed by interlaminar medial foraminotomy followed by lateral laminotomy and foraminotomy using a microsurgical technique. The procedure aimed at preserving bony continuity of the pars interarticularis and segmental motion. Neurological results showed a favourable improvement of radicular symptoms and of intermittent claudication. The need for segmental fusion at the operated segment was excluded in 30 patients, but one patient subsequently required a transpedicular screw procedure with bone grafting. We recommend the present technique for effective decompression of the nerve root within the neural foramen, simultaneously maintaining lumbar spine mobile function.

Microsurgical nerve root canal widening without fusion for lumbosacral intervertebral foraminal stenosis: technical notes and early results