title: The interspinous ligament should be removed for the decompression surgery with the case of lumbar spinal canal stenosis.
abstract: BACKGROUND
  Retrospective clinical study has done concerning the outcomes of lumbar spinal stenosis (LSS) patients treated with trans-interspinous ligament approach method. The object is to determine the efficacy of this procedure and to confirm that the interspinous ligament could be removed for the decompression surgery.
  
  
  METHODS
  Seventy patients were treated with this method and 63 patients were followed up for more than 4 years. Operative time, blood loss, complications of surgery and further surgery were checked out. During the follow-up period, JOA score and lumbar spine X-ray were evaluated.
  
  
  RESULTS
  The average operative time was 51 min, average operative time per one level was 32 min, and the average blood loss was 57 ml. The recovery rate was excellent in 26, good in 24, fair in 8 and poor in 5 patients. Four of 63 patients (6.3%) needed further surgery and among them only 2 cases (3.2%) needed reoperation because of the instability of the operative levels.
  
  
  CONCLUSIONS
  The trans-interspinous ligament procedure is a simple decompression method completed quickly and accomplishes absolute decompression for LSS. The interspinous ligament should be removed for decompression with a case of lumbar spinal canal stenosis.
authors.affiliation: Spine Center, Tokyo West Tokushukai Hospital, 3-1-1 Matsubara-cho, Akishima, Tokyo 196-0003, Japan. youhei.yuzawa@tokushukai.jp
authors.forename: Yohei
authors.initials: Y
authors.lastname: Yuzawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008022:Ligaments / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome