Abstract
The authors describe a new endoscopic technique to decompress the lumbar nerve root in elderly patients with spondylolysis. The decompression is less invasive with a small skin incision of 16 (mm). Patients are allowed to stand and to walk even on the day after surgery. Surgical indication of this procedure is as follows ; 1) without low back pain, 2) without spinal instability on dynamic radiograms, and 3) elderly.
We report two cases with spondylolysis who underwent this procedure. One patient was a 59-year-old man who is engaging in the desk work, and the other was 60-year-old woman, engaging in house work. In both cases, the L5 nerve root was compressed by the bony ragged edge of the lysis and fibrocartilaginous mass surrounding the nerve root. According to the MED method, the authors removed ligament flavum at the affected side of L4-5, and the L5 nerve root was identified. Then, the fibrocartilaginous mass and osteophyte compressing the nerve root were removed with a curette and rongeour. As a result, the leg pain disappeared, and both patients returned to their previous work three weeks following the surgery. The authors found that endoscopic decompression was an effective surgical option for treating these elderly patients with lumbar spondylolysis showing radiculolpathy. The procedure was revealed to be a useful and minimally-invasive technique that facilitated the early return to the previouswork of these patients.
