Minimally invasive surgery for spinal stenosis is gaining traction as a viable alternative to open procedures for individuals with 1 and 2 level problems of the lumbar spine. My patients who undergo decompression procedures for neurogenic claudication whether open or MIS are some of the most grateful and happy patients I see.
I believe that once a person has 3 or greater levels of stenosis that the benefits achieved with MIS surgery for stenosis are less.
Tubular lighted dilators are used to split/spread the muscles apart nontraumatically to access the specific lumbar spine levels in question. The microscope “The neurosurgeons’ best friend” is brought in with its illumination and magnification for greater field of view and accuracy.
The surgeon then “wands” the dilator, a dynamic instrument, throughout the different parts of the procedure to ultimately access both sides of the spine. By using power precision drilling, micro-instruments, and the O-arm Stealth guidance intraoperative system (see video), the relevant spine segments are decompressed without disturbing the posterior tension band or destabilizing the facet/joint complexes.
Patients wake up with a smaller incision and less pain.