Treatment of lumbar spinal stenosis by microscopic unilateral laminectomy for bilateral decompression

a technical note

Kevin Phan*, Ian Teng, Konrad Schultz, Ralph J. Mobbs

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)241–246
Number of pages6
JournalOrthopaedic surgery
Volume9
Issue number2
DOIs
Publication statusPublished - May 2017
Externally publishedYes

Keywords

  • Decompression
  • Lumbar spinal stenosis
  • Surgical technique
  • Unilateral laminectomy

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