Lumbar Lateral Recess Decompression: 2-Dimensional Operative Video
Khalsa, Siri Sahib S MD; Saadeh, Yamaan S MD; Yee, Timothy J MD; Strong, Michael J MD, PhD; Smith, Brandon W MD; Oppenlander, Mark E MD
Correspondence: Mark E. Oppenlander, MD, 1500 E. Medical Center Drive SPC 5338, Ann Arbor, MI 48109-5338, USA. Email: [email protected]
Lateral recess stenosis is a common cause of lumbar radiculopathy in adults. A lumbar nerve root travels in the lateral recess prior to exiting the spinal canal via the neural foramen. In the lateral recess, the traversing nerve root is susceptible to compression by the degenerative hypertrophy of the medial facet in addition to hypertrophied ligamentum flavum and herniated intervertebral disc.1 These degenerative changes are also typically associated with neural foraminal stenosis. Surgical treatment in unilateral cases consists of hemilaminectomy, medial facetectomy, foraminotomy, and, if applicable, microdiscectomy. In this video, we present a case of a 64-yr-old male presenting with progressive left L5 radiculopathy refractory to conservative management, with magnetic resonance imaging (MRI) findings of left L4-5 foraminal and lateral recess stenosis. We demonstrate the operative steps to complete a left L4-5 hemilaminectomy, medial facetectomy, foraminotomy, and microdiscectomy. Appropriate patient consent was obtained.
The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article. Dr Oppenlander is a consultant for Globus Medical, DePuy Spine, and LifeNet Health.
1. Ciric I, Mikhael MA, Tarkington JA, Vick NA. The lateral recess syndrome. A variant of spinal stenosis. J Neurosurg. 1980;53(4):433-443.
Keywords:Copyright © 2020 by the Congress of Neurological Surgeons
Lateral recess stenosis; Lumbar laminectomy; Lumbar radiculopathy; Spondylosis