Endoscope-assisted surgery for lateral recess stenosis of the lumbar spine

Lateral recess stenosis is caused by the arthrosic degeneration of the superior (and sometimes inferior) articular facets of the lumbo-sacral vertebrae. It is frequently found in association to spinal canal stenosis and foraminal stenosis. Patients usually manifest mono or bilateral lombalgia with sciatalgia and the L4-L5 level is the most commonly involved. Because of the high degree of radicular compression, conventional microneurosurgery may not grant adequate visualization of nerve roots, with inherent risks of nerve damage, insufficient decompression and surgical failure. The authors report a series of 19 patients affected by lateral recess syndrome treated by endoscope-assisted surgery. In this series, endoscopic observation always disclosed an incomplete enlargement of the stenotic recess at the end of conventional microneurosurgical manouvers. The use of a 45 degrees endoscope gave superb visualisation of loco-regional anatomy (greatly overwhelming microscopic vision), allowing accurate nerve root decompression and grating safeness and efficacy of treatment in most of the cases.