title: Unilateral approach for bilateral decompression of lumbar spinal stenosis: a minimal invasive surgery.
abstract: OBJECTIVE
  To assess the feasibility and efficacy of a novel, minimally invasive spinal surgery technique for the correction of lumbar spinal stenosis involving unilateral approach for bilateral decompression.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  Neurosurgery Department of PGMI, Lady Reading Hospital, Peshawar, from January to December 2010.
  
  
  METHODS
  A total of 60 patients with lumbar stenosis were randomly assigned to undergo either a conventional laminectomy (30 patients, Group A), or a unilateral approach (30 patients, Group B). Clinical outcomes was measured using the scale of Finneson and Cooper. All the data was collected by using a proforma and different parameters were assessed for a minimum follow-up period of three months. Data was analyzed by descriptive statistics using SPSS software version 17.
  
  
  RESULTS
  Adequate decompression was achieved in all patients. Compared with patients in the conventional laminectomy group, patients who received the novel procedure (unilateral approach) had a reduced mean duration of hospital stay, a faster recovery rate and majority of the patients (88.33%) had an excellent to fair operative result according to the Finneson and Cooper scale. Five major complications occurred in all patient groups, 2 patients had unintended dural rent and 2 wound dehiscence each and fifth patient had worsening of symptoms. There was no mortality in the series.
  
  
  CONCLUSIONS
  The ultimate goal of the unilateral approach to treat lumbar spinal stenosis is to achieve adequate decompression of the neural elements. An additional benefit of a minimally invasive approach is adequate preservation of vertebral stability, as it requires only minimal muscle trauma, preservation of supraspinous/intraspinous ligament complex and spinous process, therefore, allows early mobilization. This also shortens the hospital stay, reduces postoperative back pain, and leads to satisfactory outcome.
authors.affiliation: Department of Neurosurgery, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Usman
authors.forename: Mumtaz
authors.initials: M
authors.lastname: Ali
authors.forename: Khalid
authors.initials: K
authors.lastname: Khanzada
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ishaq
authors.lastname: Naeem-ul-Haq
authors.forename: Raza
authors.initials: R
authors.lastname: Aman
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ali
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D003430:Cross-Sectional Studies; D019299:Decompression, Surgical / Q000379:methods / Q000706:statistics & numerical data; D005240:Feasibility Studies; D007796:Laminectomy / Q000379:methods / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008159:Lumbar Vertebrae / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000706:statistics & numerical data; D010154:Pakistan; D011183:Postoperative Complications; D018570:Risk Assessment; D012307:Risk Factors; D013130:Spinal Stenosis / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome