2023 Volume 14 Issue 8 Pages 1086-1090
The basic surgical treatment for spinal canal lesion of lumbar spinal canal stenosis is decompression surgery. However, the endpoints of decompression surgery are unclear in many procedure manuals. The purpose of this study was to identify the location of spinal canal stenosis, posterior compression factors, and their relationship to the endpoints of the surgical procedure. The patients were 100 cases, 167 vertebrae, who underwent endoscopic laminectomy for spinal canal stenosis at our institution. Lumbar degenerative spondylolisthesis was found in 47 vertebrae (28%). Nerve compression sites were classified as high in the intervertebral disc, cephalad, or caudal to the intervertebral disc. Dorsal compression factors were also identified. Results. Nerve compression sites included cephalad to intervertebral disc in 3%, intervertebral disc only in 81%, intervertebral disc to caudal in 13%, cephalad to caudal in 1%, and caudal only in 2%. 98% of the cases included intervertebral disc. Posterior compression factors were ligamentum flavum in 91% and lipomatosis in 8%. Decompression surgery for lumbar spinal canal stenosis should be performed using the intervertebral disc as a guide for decompression and removal of the ligamentum flavum and lipomatosis at the same site.
