Minimally Invasive Decompression Techniques

Degenerative stenosis of the spinal canal is a common pathology in elderly patients most frequently affecting the lumbar and cervical spine, and decompressive laminectomy is the most commonly performed spinal procedure in patients older than 65 years of age. However, open laminectomies are known to involve risks of iatrogenic instability, increased blood loss, and spinal infection. These risk factors can be significantly reduced by performing a minimally invasive unilateral laminotomy for bilateral decompression (ULBD) through a tubular retractor. While initially introduced as a technique for decompression of degenerative lumbar spinal stenosis, this technique has more recently been applied for decompressing cervical spondylotic myelopathy and spinal stenosis as well. When applied in the right fashion, tubular ULBD is a safe and efficient technique for spinal decompression with minimal risk for iatrogenic instability.