[Selective, microsurgical cross-over decompression of multisegmental degenerative lumbar spinal stenoses: the "Slalom" technique].

OBJECTIVE

Selective, bilateral multisegmental microsurgical decompression of lumbar spinal canal stenosis through separate, alternating cross-over approaches.

INDICATIONS: Two- and multisegmental degenerative central and lateral lumbar spinal stenoses.

CONTRAINDICATIONS: None (however, if stabilization is necessary, the Slalom technique is not possible).

SURGICAL TECHNIQUE: Minimally invasive, muscle-sparing and facet-joint-sparing bilateral decompression of the lumbar spinal canal through 2 or more alternating microsurgical cross-over approaches from one side.

POSTOPERATIVE MANAGEMENT: Early mobilization 4-6 h postoperatively. Soft lumbar brace for 4 weeks (optional).

RESULTS

Between December 2010 and May 2011, the operation was performed in 35 patients (10 women; 25 men; age 71.8 years). The average time of surgery was 42 min/segment, the average blood loss was 20.3 ml/segment. Of the 35 patients, 15 did not required wound drainage. All patients were mobilized without restriction after 4-6 h, hospitalization was 5.2 days. There were 3 intraoperative complications (2 Dura lesions [5.7%] and 1 temporary L5 radiculopathy probably due to swelling of the L5 nerve root [2.8%]). Postoperatively there was a significant improvement in quality of life as measured with EQ 5D and Oswestry Disability Index as well as a significant improvement of walking distance and standing time.