Fenestration via Midline Spinous Process Spliting Approach Using METRx-MD System

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  • Yoh Masaki
    Department of Orthopeadic Surgery, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
  • Oga Masayoshi
    Department of Orthopeadic Surgery, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan

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  • ＭＥＴＲｘ‐ＭＤ　ｓｙｓｔｅｍを使用した棘突起正中縦割進入による後方除圧術

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Abstract

Recent years have seen rapid growth in the use of minimally invasive surgical procedures performed through a tubular retractor.<BR>Applying the METRx-MD system in spinous process-splitting laminectomy, a technique invented by Watanabe et al., we found that this approach resolved excessive ablation of the facet joint of unilateral fenestration and resulted in favorable surgical outcomes.<BR>The subject group consisted of 14 patients who underwent posterior decompression for lumbar spinal canal stenosis. The mean age of the subjects was 71.6 years. The mean follow-up observation period was 81.5 days. Mean JOA scores improved from 16.7 points preoperatively to 24.1 points postoperatively.<BR>Blood loss during the operation ranged from 10 to 195 g (mean blood loss for one level: 31.3 g). The time taken for the procedure ranged from 58 to 296 minutes (mean time for one level: 89.1 minutes).<BR>Fenestration via the midline spinous process-splitting approach using the METRx-MD system is capable of preserving not only the facet joint even at the upper lumbar level, but the lever arm function of the spinous process. The procedure also provides symmetrical visual fields and ease of orientation.<BR>This procedure is recommended lumbar canal stenosis at all the lumbar levels.

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