The microchannel unilateral percutaneous approach to whole exposure bilateral ligamentum flavum in the treatment of lumbar spinal canal stenosis

Abstract

Background: To explore the surgical techniques and clinical efficacy of percutaneous microchannel bilateral ligamentum flavum exposure under a microscope in the treatment of lumbar spinal stenosis. Materials and Methods: A retrospective analysis was conducted on the clinical data of 20 patients with lumbar spinal stenosis admitted to the Neurosurgery Department of the Ninth Hospital of the Joint Support Force of the People's Liberation Army from February 2020 to December 2021. The treatment of lumbar spinal stenosis was performed by exposing bilateral ligaments flavum under a minimally invasive microscope through a unilateral paravertebral approach. The duration of single segment surgery, intraoperative bleeding, hospital stay, and other indicators were recorded, as well as preoperative and postoperative JOA scores, VAS scores, and ODI index. Result: The lumbar spinal canal decompression was sufficient in this group, and there were no complications such as nerve injury and cerebrospinal fluid leakage; MRI reexamination showed good spinal canal decompression effect, and CT three-dimensional reconstruction examination showed that the minimally invasive approach to the vertebral lamina incision did not affect the stability of the spine; The JOA score, VAS score, and ODI index were significantly improved compared to before surgery (P<0.05). Follow up for 6-12 months showed improvement in symptoms in all cases, and no spinal deformities were observed during the follow-up period. Conclusion: Under the microscope, percutaneous microchannel unilateral paravertebral approach and bilateral decompression are used to treat lumbar spinal stenosis. The postoperative neurological function recovery is good, which can not only avoid damaging the paravertebral muscles, articular processes, spinous processes, and ligaments to the greatest extent, but also achieve the purpose of spinal canal decompression. It has the characteristics of minimal trauma, fast recovery, fewer complications, and good vertebral stability.