Simultaneous two-level minimally invasive lumbar laminectomy performed with dual tubular retractor systems in a 93-year-old under spinal anesthesia: illustrative case.

Abstract

Background: Lumbar spinal stenosis is a common degenerative condition in elderly patients that often requires surgical intervention. Minimally invasive techniques combined with spinal anesthesia (SA) can reduce patient complications and improve outcomes. Here the authors present the case of an elderly patient who underwent minimally invasive surgery, using dual tubular retractors and SA to address severe lumbar stenosis.

Observations: A 93-year-old female presented with severe back pain radiating bilaterally to her lower extremities. MRI demonstrated severe central canal stenosis at L4-5 and severe left lateral recess stenosis at L5-S1. Under SA, the patient underwent both L4 and L5 laminectomies simultaneously with two surgeons using dual tubular retractors. The patient was ambulatory within 4 hours of surgery with complete symptom resolution.

Lessons: SA can be utilized safely during spinal surgery in the geriatric population. The use of dual tubular retractors by two surgeons working simultaneously allows for a safe and efficient decompression of stenosis at multiple levels. Dual tubular retractors can safely be used in conjunction with SA to achieve maximal benefit to the patient and surgical efficiency. https://thejns.org/doi/10.3171/CASE2521.