Work

How I Do It: Mini-Open Decompression for Lumbar Spinal Stenosis Using the Quadrant Retractor System Without Fusion

Year: 2025

Type: article

Abstract: BACKGROUND: Minimally invasive techniques for lumbar spinal stenosis (LSS) aim to reduce soft-tissue injury while achieving adequate neural decompression. Traditional open decompression remains effective but is associated with extensive muscle dissection and prolonged recovery. Although the Quadrant retractor system is commonly used in transforaminal lumbar interbody fusion (TLIF), its application for non-fusion decompression has been seldom reported [1]. OBJECTIVE: To describe a reproducible, muscle-sparing decompression technique using the Quadrant system for central and lateral recess stenosis without instrumentation or fusion. Technique Summary: Through a paramedian Wiltse approach and a 4-5 cm vertical incision, the Quadrant retractor is docked on the facet-laminar junction [1,2]. Microscopic decompression is performed including ipsilateral laminotomy, medial facetectomy, and undercutting of the contralateral side. The technique preserves midline structures and avoids unnecessary tissue trauma [2,3]. CONCLUSION: The Quadrant-assisted decompression technique offers a safe, efficient, and minimally invasive alternative to conventional laminectomy for LSS in appropriately selected patients [9].

Source: Neurochirurgie

DOI: 10.1016/j.neuchi.2025.101742

Authors: Hamad Almarzouki Abuhussain, Kaissar Farah, Mikael Meyer, Stéphane Fuentes

Institutions: King Abdulaziz University, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille, Hôpital de la Timone

Language: English

Topic: Spine and Intervertebral Disc Pathology

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,830