Microscope-assisted bilateral cross-over decompression of spinal canal stenosis via unilateral approach

Spinal canal stenosis is quite frequently found in the degenerative lumbar spine.

Even if conservative measures are initially in the foreground, a causal therapy can ultimately only be ensured surgically. Lumbar decompression surgeries resemble one of the most commonly performed surgical spine interventions. Recently, microsurgical techniques have been established as a standard treatment option in surgical care. The ultimate goal of minimally invasive techniques is to reduce the perioperative morbidity, particularly in a predominantly elderly and frequently multi-morbid patient population, and to accelerate postoperative recovery.

As a surgical technique, bilateral decompression of spinal canal stenosis via a unilateral approach, so-called cross-over or over-the-top technique, has become the standard worldwide. The use of an optical aid, e.g. a surgical microscope, is indispensable. The spectrum of indications, surgical technique, and postoperative outcome, taking into account the international literature, are presented.