New nerve root holders during spinal decompression.

Abstract

New nerve root holders have been developed to protect nerve roots and dural sac during spinal bony decompression, especially if it takes place in the region of the lateral recess by means of a high speed air drill. Their design derives from the adaptation of common brain spatulas to the anatomy of the lumbar nerve roots. Their use, together with the contralateral approach (the operative microscopical visualization of the lesion from the side of the patient opposite to it), represents an available method to protect nervous structures from operative injuries without superfluous retraction of them. The contralateral approach permits the visualization of the deepest angles of the lateral recess without withdrawal of lateral parts of the articular facets, important for vertebral stability. In order to achieve satisfactory results without vertebral instrumental stabilization, the holder assists in the drilling procedure to enlarge the periradicular space covering the nerve root and helps avoid undue dural tearing or radicular damage.