title: Comparison of Wiltse and classical methods in surgery of lumbar spinal stenosis and spondylolisthesis.
abstract: OBJECTIVE
  Minimally invasive approaches to posterior lumbar surgery are available today that can enhance patient comfort by greatly reducing tissue damage and offer better clinical results. However, such methods have not yet gained widespread popularity despite their significant advantages. This study compares the Wiltse method and the classical method of lumbar surgery based a cohort, clinical study of 57 patients. The patients all had degenerative lumbar spinal stenosis and/or spondylolisthesis and had developed multifidus muscular atrophy.
  
  
  METHODS
  We enrolled 57 patients admitted to our clinic between April 2012 and September 2013 with a diagnosis of degenerative lumbar spinal stenosis and/or spondylolisthesis. These were treated with the classic posterior approach (n=26) or the Wiltse method (n=31).
  
  
  RESULTS
  In the classical method group, the ratio of female to male patients was 20/6 and the mean age was 58.19±10.17 years. A comparison of preoperative and postoperative multifidus muscle cross-sectional measurements (average of right and left) revealed a 36.09% atrophy level in the classical method group and a 26.34% atrophy level in the Wiltse group (p<0.01). However, atrophy development was 18.82% higher in the classical method group (p<0.05) relative to the Wiltse group.
  
  
  CONCLUSIONS
  The Wiltse method is less invasive and causes less tissue damage. It reduces the change of hemorrhage and multifidus muscles and offers a shorter duration of hospitalization with less pain.
authors.affiliation: Department of Neurosurgery, Konukoglu Hospital, Sanko University, Gaziantep, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ulutaş
authors.affiliation: Department of Neurosurgery, Sakarya University Training and Research Hospital, Sakarya, Turkey. Electronic address: drcanyaldiz@gmail.com.
authors.forename: Can
authors.initials: C
authors.lastname: Yaldız
authors.affiliation: Department of Neurosurgery, Deva Hospital, Gaziantep, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Seçer
authors.affiliation: Department of Radiology, Konukoglu Hospital, Sanko University, Gaziantep, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: İkidağ
authors.affiliation: Department of Radiology, Konukoglu Hospital, Sanko University, Gaziantep, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Cüce
authors.affiliation: Department of Neurosurgery, Koç University, İstanbul, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Yaman
authors.affiliation: Department of Neurosurgery, Neuro Spine Academy, Istanbul, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Dalbayrak
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000473:pathology*; D013130:Spinal Stenosis / Q000601:surgery*; D013168:Spondylolisthesis / Q000601:surgery*
keywords: Laminectomy; Multifidus; Spinal stenosis; Spondylolisthesis; Wiltse