Lumbar Spinal Stenosis Treated Using Minimally Invasive MicroSurgical Techniques

A thin needle is placed under fluoroscopic (x-ray) guidance down to the involved level on one side of the midline spine (Figure 6a).

Figure 6a

A small ½ to 1-inch incision is then made around this needle. Using a set of tapered metal dilators passed over the guiding needle, the tissue and muscles are then gently spread off the underlying bone (Figure 6b,c).

Figure 6b

Figure 6c

A hollow metal cylinder is then passed down to the area of the stenosis and secured. Through this working channel, a rigid surgical micro-endoscopic camera is placed to provide your surgeons with a close-up, magnified view of the pathology (Figure 6d,e).

Figure 6d

Figure 6e

With this close-up operative view, your surgeon can then microsurgically remove the bone (Figure 6f) compressing the nerve roots thereby relieving the stenosis.

Figure 6f

In addition, soft tissue such as the ligamentum flavum (Figure 6g) and herniated discs can also be removed through the MEL technique (Figure 6h). In our experience, excellent decompression of both sides of the spinal canal can be achieved through this one-sided approach.

Figure 6g

Figure 6h

In the hands of experienced spinal, the same amount of decompression can be achieved through the MEL technique as would typically be obtained through open surgery (Figure 6i).

Figure 6i

Through the same incision, the surgeon can swing the endoscope to decompress the level immediately above and below as well. Overall when compared to traditional open procedures, the MEL technique offers the attractive benefits of far less disruption of normal tissue, faster surgical time, decreased post-operative discomfort, quicker recovery time, and a typically more rapid return to normal activity. You should contact your surgeon to find out if the MEL operation is available in your area and whether or not you are a candidate for the procedure.