Journal of neurosurgery. Spine
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Clinical Trial
Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis. Technical note.
The authors applied the technique of microendoscopic discectomy to posterior decompression procedures for lumbar spinal stenosis. The purpose of this study was to determine the feasibility of using an endoscopic technique to treat lumbar spinal stenosis and to evaluate the clinical and radiographic results of microendoscopic posterior decompression (MEPD). ⋯ Microendoscopic posterior decompression is a minimally invasive procedure and is as useful as other conventional procedures in treating lumbar spinal stenosis; however, a few technical problems remain to be solved.
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Spontaneous intracranial hypotension (SIH) is an increasingly recognized syndrome associated with a specific set of clinical and imaging findings; however, determining the site of spinal cerebrospinal fluid (CSF) leakage in these patients is often difficult, and indications for surgical intervention need to be better defined. The authors report on a 55-year-old woman who presented with posture-related headache, disorientation, and memory impairment. Imaging features were consistent with SIH. ⋯ Postoperatively, there was immediate and prolonged resolution of all of her symptoms. This case of SIH was caused by transdural penetration by an anterior osteophyte and CSF leakage in the upper thoracic spine, which was treated effectively by anterior exposure and primary dural repair. Aggressive surgical intervention may be required to treat upper thoracic CSF leaks refractory to other measures.