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Sublaminar osteotomy for  lumbar spinal stenosis: Surgical technique

Published in N°012 - July / August 2021
Article viewed 23 times

Sublaminar osteotomy for lumbar spinal stenosis: Surgical technique

By V. Lamas (1), E. Laloux (2) in category SURGICAL TECHNIQUE
(1) Department of Orthopaedic Surgery and Trauma Medicine, CHU de Dijon, Dijon, France - (2) Department of Spinal Surgery, Hôpital Privé Dijon Bourgogne, France Dijon, France / [email protected]

Lumbar spinal stenosis (LSS) is the most common indication for spinal surgery in patients aged 65 and over. The ligamentum flavum contributes to the narrowing of the spinal canal. The challenge of surgical treatment for LSS is how to effectively and lastingly remove the causes of the compression whilst avoiding complications such as iatrogenic instability.

Lumbar spinal stenosis (LSS) is the most common indication for spinal surgery in patients aged 65 and over. The ligamentum flavum contributes to the narrowing of the spinal canal. The challenge of surgical treatment for LSS is how to effectively and lastingly remove the causes of the compression whilst avoiding complications such as iatrogenic instability. We describe a technique involving lumbar recalibration followed by a sublaminar osteotomy performed through enlarged interlaminar space. This technique is simple, effective, long-lasting and reproducible.

 

Introduction

Lumbar spinal stenosis (LSS) is the most common indication for spinal surgery in patients aged 65 and over [1] and the impact of a narrow spinal canal is increasing due to the ageing of the population [2]. LSS is a common degenerative condition characterized by a narrowing of the space containing the neurovascular structures of the spine and can affect both the spinal canal and foramina. It causes leg pain and intermittent neurological claudication and affects patient quality of life.

Constant mechanical stress results in degeneration and hypertrophy of the ligamentum flavum [3–5] which, combined with facet joint hypertrophy, contributes to the narrowing of the spinal canal [8] and compression of the nerve...

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