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Treatment of Lumbar Spinal Stenosis by Microscopic Unilateral Laminectomy for Bilateral Decompression: A Technical Note
Author(s) -
Phan Kevin,
Teng Ian,
Schultz Konrad,
Mobbs Ralph J
Publication year - 2017
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12335
Subject(s) - medicine , lumbar spinal stenosis , laminectomy , decompression , surgery , spinal stenosis , stenosis , lumbar , radiology , spinal cord , psychiatry
Lumbar spinal stenosis is typically a degenerative condition that leads to compression of the spinal canal and lateral recess, resulting in leg pain and walking disability. Surgical management is indicated after failure of non‐surgical management or rapidly worsening neurological impairment. The traditional approach is a laminectomy with foraminotomy and partial facetectomy but a newer minimally invasive option, unilateral laminectomy for bilateral decompression ( ULBD ), seems to demonstrate the better postoperative outcomes due to its unilateral exposure. ULBD involves a midline incision, opening the thoracolumbar fascia, retracting the paravertebral muscles unilaterally, then a hemilaminectomy, flavectomy, and decompression of the spinal canal with foraminotomy or partial facetectomy. The clinical decision on which side to approach spinal stenosis with ULBD has not been discussed in the literature. We have come up with an algorithm to decide which side to approach for ULBD based on position of spinous process and angulation, side of maximal compression, and surgeon handedness.

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