Walter Bini
Healthpoint Hospital, UAE
Title: Lumbar spinal canal stenosis: Surgical management strategies, quo vadis (where to)
Biography
Biography: Walter Bini
Abstract
Lumbar spinal stenosis (LSS) is characterized by a narrowing of the lumbar spinal canal and/or the intervertebral foramina resulting from disc degeneration, bulging of the annulus, facet joint hypertrophy and infolding of the ligamentum flavum. With increase of the aging population and advances in diagnostic imaging capabilities, lumbar spinal stenosis in its different stages or types is becoming more frequently diagnosed with an estimated prevalence of up to 13%. This along with newer technical advances being introduced in the surgical management of LSS continues to pose a topic of discussion among neurologists as well as orthopedic and neurosurgeons as far as treatment strategies are concerned.
Especially the cases of moderate or soft stenosis, very different than the bony or consolidated type, warrant a detailed analysis of the primary interspinous devices used for both types along with a proposal for a decision making protocol. Based on our experience with the management of these two entities, we will focus on our results and future considerations with less invasive procedures which are proving over the last two decades to be a viable alternative for stenosis patients. Core of our presentation are our results with a minimal invasive procedure performed in 121 patients and their corresponding initial follow-up over one year with a 92% success rate evaluated by an independent observer. This is clearly in contrast with the 40-90% success rates and 14-35% complication rates reported and associated with standard decompression surgeries. Furthermore, we will present our considerations of a further novel technique and the direction treatment options are developing towards the corresponding scheduled clinical-trial.