title: Clinical results of microsurgical bilateral decompression via unilateral approach for lumbar canal stenosis with multiple-level involvement.
abstract: OBJECTIVE
  Microsurgical decompression of the lumbar spine is a beneficial approach for selected patients of lumbar spinal stenosis (LSS). The purpose of this prospective study was to describe the clinical results of surgical treatment for microsurgical bilateral decompression via unilateral approach on patients with LSS with multiple-level involvement.
  
  
  METHODS
  Seventy-three consecutive patients who had microsurgical bilateral decompression via unilateral approach of more than two spinal levels were included in this study. Seventy-seven patients who had surgery at a single level over the same time periods were compared as a single-level LSS group.
  
  
  RESULTS
  The preoperative Japanese Orthopaedic Association scores averaged 11.7 points, and the postoperative scores averaged 21.2 points with an average recovery rate (RR) of 56% in the multiple-level LSS group. There was no significant difference in the RR between the groups. There were no major complications related to the surgery in the both groups.
  
  
  CONCLUSIONS
  Microsurgical bilateral decompression via unilateral approach was a useful and safe operative procedure for LSS patients. Sufficient clinical results that were comparable to single-level LSS patients were obtained even in the patients with multiple-level LSS, if the patient were correctly selected and the microsurgical decompression surgery were carefully performed.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan, nobut@hiroshima-u.ac.jp.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanaka
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Naosuke
authors.initials: N
authors.lastname: Kamei
authors.forename: Risako
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakamae
authors.forename: Bunichiro
authors.initials: B
authors.lastname: Izumi
authors.forename: Ryo
authors.initials: R
authors.lastname: Ohta
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujioka
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ochi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects; D008875:Middle Aged; D061646:Operative Time; D011128:Polyradiculopathy / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D011843:Radiculopathy / Q000209:etiology / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012720:Severity of Illness Index; D013130:Spinal Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome