Lumbar spinal stenosis

Abstract

Over the last few decades, minimally invasive decompression techniques have been developed concurrently with technical advances of retractors, instruments, and visualization tools. Techniques allowing bilateral decompression from a unilateral approach can limit soft tissue disruption and still allow for adequate decompression of the neural elements. Multiple case series have demonstrated equivalent clinical outcomes, a complication profile that is favorable compared to conventional open laminectomy, and comparative studies have shown the benefit of the minimally invasive approach especifically toward reducing perioperative morbidity and postoperative wound infection rates. The role of interspinous process devices for decompression and stabilization when addressing pathology associated with lumbar spinal stenosis is controversial. This chapter discusses the application of minimally invasive techniques for the treatment of lumbar spinal stenosis and includes indications, outcomes, and complications associated with these techniques.