Bilateral decompression via unilateral fenestration using mobile microendoscopic discectomy technique for lumbar spinal stenosis.

ABSTRACT

OBJECTIVE: To evaluate the feasibility and clinical efficacy of bilateral decompression via unilateral fenestration (BDUF) with mobile microendoscopic discectomy (MMED) for lumbar spinal stenosis. METHODS: From June 2007 to June 2009, 32 patients were treated by the technique of BDUF with MMED for lumbar spinal stenosis in our hospital. All patients complained of bilateral sciatic neuralgia and intermittent claudication that was dominant in one limb. CT scan and MRI revealed disc herniation and bilateral stenosis of the spinal canal. Patients with bilateral severe osseous stenosis and multilevel stenosis were excluded. RESULTS: The procedure was technically successful in all patients, bilateral decompression and spinal canal enlargement being achieved by unilateral fenestration. The mean operative time was 70 min (range, 50-100 min), with a mean blood loss of 150 ml (range, 50-350 ml). No significant complication was noted; dural tears were encountered in only two patients without obvious side effects. The patients were followed up for 3 to 24 months (mean, 12 months) and the clinical results were excellent in 21 cases and good in 11 cases according to the MacNab scale. CONCLUSION: The procedure of BDUF can be performed in conjunction with the MMED technique for lumbar spinal stenosis with good clinical results; however, severe bilateral osseous stenosis may be not suitable for this technique.