Microdecompression for lumbar spinal canal stenosis

Study Design. A description of the technique for lumbar microdecompression and a prospective study of the outcomes. Objective. To describe and analyze a technique that affords an excellent decompression while minimizing damage to surrounding tissues. Summary of Background Data. Commonly used techniques of lumbar decompression that include bilateral takedown of paraspinal musculature and aggressive bony resection can result in significant iatrogenic sequelae. A less destructive alternative is needed. Methods. Unilateral limited takedown of multifidus was undertaken, and ipsilateral decompression performed. The contralateral side then was addressed under the midline structures with microscopic visualization - thereby preserving the supra-/interspinous ligament complex and the contralateral musculature. Thirty consecutive patients undergoing the procedure were analyzed prospectively and after a follow-up period by independent observers using a modified validated functional outcome score and patient satisfaction measures. Results. The technique affords an excellent decompression while minimizing destruction to tissues not directly involved in the pathologic process. Functional outcome scores doubled, and 87% of patients reported high satisfaction rates. Conclusions. Lumbar microdecompression is a minimally invasive technique that appears to provide excellent functional outcomes.