Abstract

Study Design: Endoscopic technique has been used by the author since 1993 for lumbar discectomy and since 2001 for spinal stenosis. The technique is described and the results of 145 patients are presented. Material and Methods: The device (Endospine, Karl Storz GmbH, Tuttlingen, Germany) is composed of three tubes: one for the endoscope, one for suction and the largest one for classical surgical instruments. Since 2001 this endoscopic technique has been used in spinal stenosis performing a bilateral decompression through a posterior approach from the left side or from the side of predominant signs. From February 2001 to September 2007, 145 patients have been operated on with this technique. In 83% surgery was a single level decompression and in 16% there was an associated spondylolisthesis. Prolo�s criteria were used. Results: 104 questionnaires (72%) were returned showing excellent results in 94 cases (90%) and poor in 9 (8,7%). With an average delay of 3 weeks, 94 patients (90%) returned to a normal life. Four patients (4%) needed a second operation with an average delay of 5 months. The complications observed were: dural tear in 12 (8,3%); nerve root lesion in 3 (2%); resection of articular process in 7 4,8%); wrong level decompression in 2 (1,4%); and 1 compressive hematoma. In answer to the questions on global satisfaction and on the accuracy of the information given before surgery, 97% responded as satisfied and 95% felt the information given to be accurate. Conclusions: This minimally invasive technique is mainly used in single level spinal stenosis even with associated spondylolisthesis, but can be also used in several levels decompression. The good results and the fast resumption of normal activities explain that this endoscopic technique could become the gold standard in spinal stenosis, pathology that will increase with the lifespan extension