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Unlike traditional open laminectomy, minimally invasive decompression (MID) spares the important midline structures of the spine (i.e., the spinous process and the supraspinous and interspinous ligaments). The benefits are faster recovery, fewer instability problems, and fewer complications1,2. The procedure can be used in most patients with lumbar spinal stenosis, including those with recess stenosis and those who have had reoperations. However, the procedure may have a steeper learning curve, and for some patients, especially those who have complex scoliosis or who are obese, laminectomy offers the open view that is needed. Minimally invasive spine surgery has become increasingly popular, and the method of minimally invasive decompression in lumbar spinal stenosis has been described in several papers3-6.
We describe a step-by-step approach to this procedure. Our aim was to provide the steps of this common procedure for surgeons who are at an early stage of adopting this approach. As with any procedure, experience leads to personal preferences; however, the basic steps that we describe should remain the same. Establishing a routine of steps to identify key anatomic landmarks will lead to the avoidance of common pitfalls.
