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Tandem Microscopic Slalom Technique: The Use of 2 Microscopes Simultaneously Performing Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Spinal Stenosis

STUDY DESIGN: Technical note, retrospective case series. OBJECTIVE: Lumbar stenosis can be effectively treated using tubular unilateral laminotomy for bilateral decompression (ULBD). For multilevel stenosis, a multilevel ULBD through separate, alternating crossover approaches has been described as t...

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Autores principales: Wipplinger, Christoph, Kim, Eliana, Lener, Sara, Navarro-Ramirez, Rodrigo, Kirnaz, Sertac, Hernandez, R. Nick, Melcher, Carolin, Paolicelli, Michelle, Maryam, Farah, Schmidt, Franziska Anna, Härtl, Roger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263332/
https://www.ncbi.nlm.nih.gov/pubmed/32528812
http://dx.doi.org/10.1177/2192568219871918
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author Wipplinger, Christoph
Kim, Eliana
Lener, Sara
Navarro-Ramirez, Rodrigo
Kirnaz, Sertac
Hernandez, R. Nick
Melcher, Carolin
Paolicelli, Michelle
Maryam, Farah
Schmidt, Franziska Anna
Härtl, Roger
author_facet Wipplinger, Christoph
Kim, Eliana
Lener, Sara
Navarro-Ramirez, Rodrigo
Kirnaz, Sertac
Hernandez, R. Nick
Melcher, Carolin
Paolicelli, Michelle
Maryam, Farah
Schmidt, Franziska Anna
Härtl, Roger
author_sort Wipplinger, Christoph
collection PubMed
description STUDY DESIGN: Technical note, retrospective case series. OBJECTIVE: Lumbar stenosis can be effectively treated using tubular unilateral laminotomy for bilateral decompression (ULBD). For multilevel stenosis, a multilevel ULBD through separate, alternating crossover approaches has been described as the “slalom technique.” To increase efficacy, we introduced this approach with 2 microscopes simultaneously. METHODS: We collected data on 13 patients, with multilevel lumbar stenosis, operated at our institution between 2015 and 2016 by the aforementioned technique. We assessed surgical time (ST), estimated blood loss (EBL), complications, and revision surgeries. Furthermore, we provide a stepwise instruction for performing the tandem microscopic slalom technique in a safe and efficient manner. RESULTS: The mean age of the patients was 68 ± 8 years. The ST per level was 68 ± 19 minutes with an EBL per level of 39 ± 30 mL. We had no intraoperative complications and none of our patients required a revision surgery during a mean follow-up of 12 months. CONCLUSIONS: We have shown that this technique is feasible and can be performed safely for multisegmental lumbar spinal stenosis with minimal tissue trauma and low EBL. Furthermore, randomized controlled studies with a larger sample size may be necessary to drive any final conclusions.
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spelling pubmed-72633322020-06-10 Tandem Microscopic Slalom Technique: The Use of 2 Microscopes Simultaneously Performing Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Spinal Stenosis Wipplinger, Christoph Kim, Eliana Lener, Sara Navarro-Ramirez, Rodrigo Kirnaz, Sertac Hernandez, R. Nick Melcher, Carolin Paolicelli, Michelle Maryam, Farah Schmidt, Franziska Anna Härtl, Roger Global Spine J Technique STUDY DESIGN: Technical note, retrospective case series. OBJECTIVE: Lumbar stenosis can be effectively treated using tubular unilateral laminotomy for bilateral decompression (ULBD). For multilevel stenosis, a multilevel ULBD through separate, alternating crossover approaches has been described as the “slalom technique.” To increase efficacy, we introduced this approach with 2 microscopes simultaneously. METHODS: We collected data on 13 patients, with multilevel lumbar stenosis, operated at our institution between 2015 and 2016 by the aforementioned technique. We assessed surgical time (ST), estimated blood loss (EBL), complications, and revision surgeries. Furthermore, we provide a stepwise instruction for performing the tandem microscopic slalom technique in a safe and efficient manner. RESULTS: The mean age of the patients was 68 ± 8 years. The ST per level was 68 ± 19 minutes with an EBL per level of 39 ± 30 mL. We had no intraoperative complications and none of our patients required a revision surgery during a mean follow-up of 12 months. CONCLUSIONS: We have shown that this technique is feasible and can be performed safely for multisegmental lumbar spinal stenosis with minimal tissue trauma and low EBL. Furthermore, randomized controlled studies with a larger sample size may be necessary to drive any final conclusions. SAGE Publications 2020-05-28 2020-04 /pmc/articles/PMC7263332/ /pubmed/32528812 http://dx.doi.org/10.1177/2192568219871918 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Technique
Wipplinger, Christoph
Kim, Eliana
Lener, Sara
Navarro-Ramirez, Rodrigo
Kirnaz, Sertac
Hernandez, R. Nick
Melcher, Carolin
Paolicelli, Michelle
Maryam, Farah
Schmidt, Franziska Anna
Härtl, Roger
Tandem Microscopic Slalom Technique: The Use of 2 Microscopes Simultaneously Performing Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Spinal Stenosis
title Tandem Microscopic Slalom Technique: The Use of 2 Microscopes Simultaneously Performing Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Spinal Stenosis
title_full Tandem Microscopic Slalom Technique: The Use of 2 Microscopes Simultaneously Performing Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Spinal Stenosis
title_fullStr Tandem Microscopic Slalom Technique: The Use of 2 Microscopes Simultaneously Performing Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Spinal Stenosis
title_full_unstemmed Tandem Microscopic Slalom Technique: The Use of 2 Microscopes Simultaneously Performing Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Spinal Stenosis
title_short Tandem Microscopic Slalom Technique: The Use of 2 Microscopes Simultaneously Performing Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Spinal Stenosis
title_sort tandem microscopic slalom technique: the use of 2 microscopes simultaneously performing unilateral laminotomy for bilateral decompression in multilevel lumbar spinal stenosis
topic Technique
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263332/
https://www.ncbi.nlm.nih.gov/pubmed/32528812
http://dx.doi.org/10.1177/2192568219871918
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