Partial pediculectomy in the treatment of lumbar spinal stenosis: Technical note

Jonas M. Sheehan, Gregory A. Helm, David F Kallmes, Christopher A. Bogaev, John A. Jane

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

OBJECTIVE: We note an additional pathological condition associated with lumbar spinal stenosis that may be responsible for significant postoperative pain. Recognizing that nerve roots are stretched around hypertrophic pedicles in some cases of spinal stenosis, we have altered our surgical management of these cases to address what may be a previously unrecognized but significant anatomic pathological finding. SURGICAL TECHNIQUE: After ipsilateral posterior bony decompression of the spinal canal, the nerve root is examined as it courses around the pedicle. If the root appears stretched, the medial part of the pedicle is removed using first a diamond bit and then a curet. The nerve root is retracted and protected during this procedure. RESULTS: Inspection of the root after partial pediculectomy frequently reveals lateral movement of the root into space previously occupied by the pedicle. Anatomically, the nerve is better decompressed and free of obstruction. This technique adds little time to the overall duration of the operation. CONCLUSION: Anatomic evidence obtained through intraoperative examination and preoperative imaging techniques indicates that partial pediculectomy may play a role in the treatment of some cases of lumbar stenosis.

Original languageEnglish (US)
Pages (from-to)308-310
Number of pages3
JournalNeurosurgery
Volume41
Issue number1
DOIs
StatePublished - Jul 1997
Externally publishedYes

    Fingerprint

Keywords

  • Lumbar spine
  • Nerve root
  • Pedicle
  • Pediculectomy
  • Spinal stenosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this