Introduction: We have reported the good results of endoscopic bilateral nerve roots decompression by unilateral posterior approach for the patients with lumbar spinal canal stenosis who suffered from symptom in their bilateral lower limbs. It was found that one of the largest drawbacks to success in endoscopic spine surgery is surgeons's disorientation as to the anatomy. Recently, computer-assisted navigation systems have been developed for clinical use. However, it is still unknown if a computer-assisted navigation system can result in avoidance of this complication in microendoscopic laminotomy (MEL) for patients with lumbar spinal canal stenosis. The purpose of this study was to clarify the efficacy and accuracy of the navigation system in MEL for lumbar spinal canal stenosis. Methods: From November 2004 to April 2005, twenty-four patients underwent MEL for lumbar spinal canal stenosis combined with a navigation system (Vector Vision; BrainLAB GmbH, Germany or Stealth Station; Medtronic Navigation, Minneapolis USA). The lumbar spine of patients was registered by correlating the anteroposterior and lateral fluoroscopic images during surgery with the virtual three-dimensional images reconstructed preoperative computerized axial tomography scan (CAT scan). Total thirty-one levels, in which the cauda equina and the nerve root were successfully decompressed in these patients, were used for evaluation of identification between navigation images and postoperative CAT scan.
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