ULTRASOUND-GUIDED DECOMPRESSION OF BILATERAL LUMBAR STENOSIS VIA AN UNILATERAL APPROACH

Problemstellung: Usually, degenerative lumbar stenosis is operated upon via laminectomy or bilateral interlaminar fenestration. Unilateral fenestration and decompression of the contralateral nerve root by “undercutting“ lacks visual control. We evaluated the value of intraoperative ultrasound for reduction of the approach for lumbar stenosis.

Methoden: Fifteen patients suffering from bilateral exercise-induced radicular pain caused by lumbar stenosis were operated upon by unilateral interlaminar fenestration on the side of the predominant pain. The contralateral side was decompressed via undercutting. The extent of decompression was visualised by a 7.5MHz ultrasound probe with a small tip.

Ergebnisse: After decompression, the contralateral root could be seen as well as the ipsilateral root in all patients. The diameter of the spinal canal could be measured. Postoperatively, 14 patients were pain free.

No injury to the contralateral root was observed intraoperatively.

Schlussfolgerungen: Intaoperative ultrasound may facilitate unilateral decompression of bilateral lumbar stenosis, resulting in a reduction of intraoperative trauma.